Provider Demographics
NPI:1639799885
Name:OHIO RBE LLC
Entity Type:Organization
Organization Name:OHIO RBE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP SENIOR SERVICES/GENERAL COUNSEL
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DIMICKELE
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:614-273-3802
Mailing Address - Street 1:2245 N BANK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-5422
Mailing Address - Country:US
Mailing Address - Phone:614-582-6406
Mailing Address - Fax:717-591-6330
Practice Address - Street 1:1700 E DUBLIN GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3525
Practice Address - Country:US
Practice Address - Phone:614-582-6406
Practice Address - Fax:717-591-6330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty