Provider Demographics
NPI:1699824284
Name:PERFUSION TECHNOLOGIES
Entity Type:Organization
Organization Name:PERFUSION TECHNOLOGIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KONICKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:937-436-2880
Mailing Address - Street 1:4384 LAC LAMEN DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-5400
Mailing Address - Country:US
Mailing Address - Phone:937-436-2880
Mailing Address - Fax:937-436-2880
Practice Address - Street 1:4384 LAC LAMEN DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-5400
Practice Address - Country:US
Practice Address - Phone:937-436-2880
Practice Address - Fax:937-436-2880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN234035374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374700000XNursing Service Related ProvidersTechnicianGroup - Single Specialty