Provider Demographics
NPI:1841903812
Name:RC & R EXPEDITED HOLDINGS
Entity type:Organization
Organization Name:RC & R EXPEDITED HOLDINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAPHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FOMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-830-4682
Mailing Address - Street 1:3330 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-4027
Mailing Address - Country:US
Mailing Address - Phone:202-830-4682
Mailing Address - Fax:
Practice Address - Street 1:3330 CREEKSIDE DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-4027
Practice Address - Country:US
Practice Address - Phone:202-830-4682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness