Provider Demographics
NPI:1871241034
Name:RUTH ANN'S DESSERTS LLC
Entity Type:Organization
Organization Name:RUTH ANN'S DESSERTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHONDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-993-2671
Mailing Address - Street 1:18020 JOHN AVE
Mailing Address - Street 2:
Mailing Address - City:COUNTRY CLUB HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60478-5018
Mailing Address - Country:US
Mailing Address - Phone:773-993-2671
Mailing Address - Fax:
Practice Address - Street 1:18020 JOHN AVE
Practice Address - Street 2:
Practice Address - City:COUNTRY CLUB HILLS
Practice Address - State:IL
Practice Address - Zip Code:60478-5018
Practice Address - Country:US
Practice Address - Phone:773-993-2671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory