Provider Demographics
NPI:1780237537
Name:RAHCO KENTUCKIANA, LLC
Entity type:Organization
Organization Name:RAHCO KENTUCKIANA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-535-7540
Mailing Address - Street 1:310 WINSTON CT
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-8802
Mailing Address - Country:US
Mailing Address - Phone:502-897-0580
Mailing Address - Fax:502-897-0581
Practice Address - Street 1:500 EXECUTIVE PARK
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4205
Practice Address - Country:US
Practice Address - Phone:502-897-0580
Practice Address - Fax:502-897-0581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care