Provider Demographics
NPI:1649886144
Name:URICK, RENE
Entity type:Individual
Prefix:MRS
First Name:RENE
Middle Name:
Last Name:URICK
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 1:25889 CHURCHMAN ADDITION
Mailing Address - Street 2:
Mailing Address - City:QUAKER CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43773-9118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25889 CHURCHMAN ADDITION
Practice Address - Street 2:
Practice Address - City:QUAKER CITY
Practice Address - State:OH
Practice Address - Zip Code:43773-9118
Practice Address - Country:US
Practice Address - Phone:740-680-1941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-20
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care