Provider Demographics
NPI:1841608247
Name:R&R RAPID RESPONSE PROFESSIONAL MEDIAL AGENCY LLC
Entity Type:Organization
Organization Name:R&R RAPID RESPONSE PROFESSIONAL MEDIAL AGENCY LLC
Other - Org Name:R&R RAPID RESPONSE PROFESSIONAL HEALTHCARE STAFFING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GWENNETTE
Authorized Official - Middle Name:CARMELLA
Authorized Official - Last Name:BODDIE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:863-353-2612
Mailing Address - Street 1:40230 US HIGHWAY 27 N STE 140
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-2636
Mailing Address - Country:US
Mailing Address - Phone:863-353-2612
Mailing Address - Fax:863-438-7928
Practice Address - Street 1:40230 US HIGHWAY 27 N STE 140
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-2636
Practice Address - Country:US
Practice Address - Phone:863-353-2612
Practice Address - Fax:863-438-7928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1724251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion