Provider Demographics
NPI:1689868374
Name:RAMBACHER CHIROPRACTIC INC
Entity Type:Organization
Organization Name:RAMBACHER CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:NACEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-625-3974
Mailing Address - Street 1:441 MARS VALENCIA RD
Mailing Address - Street 2:PO BOX 487
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046
Mailing Address - Country:US
Mailing Address - Phone:724-625-3974
Mailing Address - Fax:724-625-3973
Practice Address - Street 1:441 MARS VALENCIA RD
Practice Address - Street 2:
Practice Address - City:MARS
Practice Address - State:PA
Practice Address - Zip Code:16046
Practice Address - Country:US
Practice Address - Phone:724-625-3974
Practice Address - Fax:724-625-3973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003973L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101958517 0001Medicaid
PA520513Medicare PIN
PAU11538Medicare UPIN