Provider Demographics
NPI:1710383096
Name:RUGO MEDICAL, LLC
Entity Type:Organization
Organization Name:RUGO MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAITLYN
Authorized Official - Middle Name:LORENE
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-897-3482
Mailing Address - Street 1:13201 NORTHWEST FREEWAY
Mailing Address - Street 2:STE 260
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040
Mailing Address - Country:US
Mailing Address - Phone:972-897-3482
Mailing Address - Fax:
Practice Address - Street 1:13201 NORTHWEST FREEWAY
Practice Address - Street 2:STE 260
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040
Practice Address - Country:US
Practice Address - Phone:972-897-3482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies