Provider Demographics
NPI:1801401302
Name:JONES, RUTH
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3347 W ALEX BELL RD
Mailing Address - Street 2:
Mailing Address - City:WEST CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-2816
Mailing Address - Country:US
Mailing Address - Phone:937-369-7045
Mailing Address - Fax:937-294-7045
Practice Address - Street 1:3347 W ALEX BELL RD
Practice Address - Street 2:
Practice Address - City:WEST CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:45449-2816
Practice Address - Country:US
Practice Address - Phone:937-369-7045
Practice Address - Fax:937-294-7045
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000096211374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0096211Medicaid