Provider Demographics
NPI:1487808697
Name:RUDOLPH ENTERPRISES LLC
Entity type:Organization
Organization Name:RUDOLPH ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:RUDOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:FACHE, CSA
Authorized Official - Phone:608-442-1898
Mailing Address - Street 1:5396 KING JAMES WAY STE 210
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1798
Mailing Address - Country:US
Mailing Address - Phone:608-442-1898
Mailing Address - Fax:608-442-1899
Practice Address - Street 1:5396 KING JAMES WAY STE 210
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53719-1798
Practice Address - Country:US
Practice Address - Phone:608-442-1898
Practice Address - Fax:608-442-1899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care