Provider Demographics
NPI:1104328533
Name:RT AUTOMOTIVE, INC.
Entity type:Organization
Organization Name:RT AUTOMOTIVE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-859-2933
Mailing Address - Street 1:16294 STATE HIGHWAY 135
Mailing Address - Street 2:
Mailing Address - City:ARP
Mailing Address - State:TX
Mailing Address - Zip Code:75750-9406
Mailing Address - Country:US
Mailing Address - Phone:903-859-2933
Mailing Address - Fax:903-859-2933
Practice Address - Street 1:24086 FM 838 W
Practice Address - Street 2:
Practice Address - City:OVERTON
Practice Address - State:TX
Practice Address - Zip Code:75684-4427
Practice Address - Country:US
Practice Address - Phone:903-859-2933
Practice Address - Fax:903-859-2933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies