Provider Demographics
NPI:1568110211
Name:RSH WELLNESS, LLC
Entity Type:Organization
Organization Name:RSH WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HAUTER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:989-330-2589
Mailing Address - Street 1:5103 W PIERSON RD STE 3
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-1395
Mailing Address - Country:US
Mailing Address - Phone:810-339-6607
Mailing Address - Fax:810-339-6848
Practice Address - Street 1:5103 W PIERSON RD STE 3
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-1395
Practice Address - Country:US
Practice Address - Phone:810-339-6607
Practice Address - Fax:810-339-6848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care