Provider Demographics
NPI:1336973452
Name:REYES, RAINIER C
Entity type:Individual
Prefix:
First Name:RAINIER
Middle Name:C
Last Name:REYES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 HAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-1925
Mailing Address - Country:US
Mailing Address - Phone:216-347-0107
Mailing Address - Fax:
Practice Address - Street 1:1003 HAMPTON DR
Practice Address - Street 2:
Practice Address - City:MACEDONIA
Practice Address - State:OH
Practice Address - Zip Code:44056-1925
Practice Address - Country:US
Practice Address - Phone:216-347-0107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7248255179246Z00000X
OHRU837343172A00000X, 343900000X, 347C00000X
251X00000X, 253Z00000X, 3747P1801X, 376J00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No172A00000XOther Service ProvidersDriver
No251X00000XAgenciesSupports Brokerage
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
No385H00000XRespite Care FacilityRespite Care