Provider Demographics
NPI:1811337330
Name:RHONDA BODAGER
Entity type:Organization
Organization Name:RHONDA BODAGER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STATE TESTED NURSING ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BODAGER
Authorized Official - Suffix:
Authorized Official - Credentials:STNA
Authorized Official - Phone:419-651-3321
Mailing Address - Street 1:9536 MATTY RD
Mailing Address - Street 2:
Mailing Address - City:WEST SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44287-9722
Mailing Address - Country:US
Mailing Address - Phone:419-651-3321
Mailing Address - Fax:
Practice Address - Street 1:9536 MATTY RD
Practice Address - Street 2:
Practice Address - City:WEST SALEM
Practice Address - State:OH
Practice Address - Zip Code:44287-9722
Practice Address - Country:US
Practice Address - Phone:419-651-3321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric