Provider Demographics
NPI:1710691852
Name:RUBICON BUSINESS VENTURES
Entity Type:Organization
Organization Name:RUBICON BUSINESS VENTURES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILD JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-429-9561
Mailing Address - Street 1:400 N WILLIAM ST STE 104
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-2802
Mailing Address - Country:US
Mailing Address - Phone:919-684-6806
Mailing Address - Fax:
Practice Address - Street 1:400 N WILLIAM ST STE 104
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-2802
Practice Address - Country:US
Practice Address - Phone:919-684-6806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care