Provider Demographics
NPI:1720345507
Name:PT RUB MED, LLC
Entity Type:Organization
Organization Name:PT RUB MED, LLC
Other - Org Name:NULIFE MED, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HRADECKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-860-1035
Mailing Address - Street 1:816 ELM ST # 207
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-2105
Mailing Address - Country:US
Mailing Address - Phone:603-860-1035
Mailing Address - Fax:603-899-9977
Practice Address - Street 1:816 ELM ST # 207
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-2105
Practice Address - Country:US
Practice Address - Phone:603-860-1035
Practice Address - Fax:603-899-9977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment