Provider Demographics
NPI:1740389287
Name:RGS HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:RGS HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LANE
Authorized Official - Middle Name:
Authorized Official - Last Name:NAKASONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-504-2867
Mailing Address - Street 1:11000 RANDALL ST.
Mailing Address - Street 2:UNIT A
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-2621
Mailing Address - Country:US
Mailing Address - Phone:818-504-2867
Mailing Address - Fax:818-504-2768
Practice Address - Street 1:11000 RANDALL ST.
Practice Address - Street 2:UNIT A
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-2621
Practice Address - Country:US
Practice Address - Phone:818-504-2867
Practice Address - Fax:818-504-2768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45320332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5801160001Medicare NSC