Provider Demographics
NPI:1760628135
Name:RUDMAN LLC
Entity type:Organization
Organization Name:RUDMAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-695-7557
Mailing Address - Street 1:4530 W 157TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44135-2734
Mailing Address - Country:US
Mailing Address - Phone:216-695-7557
Mailing Address - Fax:216-265-8279
Practice Address - Street 1:241 MILL ST
Practice Address - Street 2:STE C
Practice Address - City:CONNEAUT
Practice Address - State:OH
Practice Address - Zip Code:44030-2529
Practice Address - Country:US
Practice Address - Phone:216-695-7557
Practice Address - Fax:216-265-8279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRT667557343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)