Provider Demographics
NPI:1962461913
Name:CORPORATE HEALTH SERVICES OF MARY RUTAN HEALTH ASSOCIATION
Entity Type:Organization
Organization Name:CORPORATE HEALTH SERVICES OF MARY RUTAN HEALTH ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-592-4015
Mailing Address - Street 1:205 E PALMER RD
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-2281
Mailing Address - Country:US
Mailing Address - Phone:937-592-4015
Mailing Address - Fax:
Practice Address - Street 1:205 E PALMER RD
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-2281
Practice Address - Country:US
Practice Address - Phone:937-592-4015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARY RUTAN HEALTH ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-20
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health