Provider Demographics
NPI:1952737793
Name:RSWC
Entity Type:Organization
Organization Name:RSWC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-749-5189
Mailing Address - Street 1:1365 N JOHNSON AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-1649
Mailing Address - Country:US
Mailing Address - Phone:619-749-5189
Mailing Address - Fax:619-599-8300
Practice Address - Street 1:9640B MISSION GORGE RD # 338
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-3806
Practice Address - Country:US
Practice Address - Phone:619-749-5189
Practice Address - Fax:619-599-8300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB2011026211343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6470240Medicaid