Provider Demographics
NPI:1548501539
Name:RENAISSANCE HEALTHCARE LLC
Entity type:Organization
Organization Name:RENAISSANCE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:N
Authorized Official - Last Name:OLAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-626-2101
Mailing Address - Street 1:6422 E MAIN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-2302
Mailing Address - Country:US
Mailing Address - Phone:614-626-2101
Mailing Address - Fax:614-626-2501
Practice Address - Street 1:6422 E MAIN ST STE 205
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2302
Practice Address - Country:US
Practice Address - Phone:614-626-2101
Practice Address - Fax:614-626-2501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-15
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health