Provider Demographics
NPI:1255584827
Name:R & G AMBULATORY SERVICES LLC
Entity type:Organization
Organization Name:R & G AMBULATORY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER, BUSINESS OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:OLMSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:BUSINESS OWNER, MEMB
Authorized Official - Phone:810-732-8536
Mailing Address - Street 1:4511 MILLER ROAD
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507
Mailing Address - Country:US
Mailing Address - Phone:810-732-8536
Mailing Address - Fax:810-732-8566
Practice Address - Street 1:4511 MILLER ROAD
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507
Practice Address - Country:US
Practice Address - Phone:810-732-8536
Practice Address - Fax:810-732-8566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty