Provider Demographics
NPI:1689990483
Name:RCHP-OTTUMWA LLC
Entity Type:Organization
Organization Name:RCHP-OTTUMWA LLC
Other - Org Name:OTTUMWA REGIONAL HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:TEAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-920-7000
Mailing Address - Street 1:1011 PENNSYLVANIA AVENUE
Mailing Address - Street 2:SUITE D
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-2108
Mailing Address - Country:US
Mailing Address - Phone:641-684-3136
Mailing Address - Fax:641-682-1237
Practice Address - Street 1:1011 PENNSYLVANIA AVENUE
Practice Address - Street 2:SUITE D
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2108
Practice Address - Country:US
Practice Address - Phone:641-684-3136
Practice Address - Fax:641-682-1237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
167176Medicare Oscar/Certification