Provider Demographics
NPI:1679034391
Name:RUCKER HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:RUCKER HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ RESPIRATORY THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMEL
Authorized Official - Middle Name:AMELE
Authorized Official - Last Name:RUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:BS, RRT
Authorized Official - Phone:407-457-0153
Mailing Address - Street 1:4000 NEW BROAD CIR APT 204
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-7327
Mailing Address - Country:US
Mailing Address - Phone:407-457-0153
Mailing Address - Fax:
Practice Address - Street 1:4000 NEW BROAD CIR APT 204
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-7327
Practice Address - Country:US
Practice Address - Phone:407-457-0153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RUCKER HEALTHCARE SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-26
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Single Specialty
No2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome HealthGroup - Single Specialty
No251E00000XAgenciesHome Health