Provider Demographics
NPI:1528263332
Name:RAMPART GROUP INC
Entity type:Organization
Organization Name:RAMPART GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-631-9014
Mailing Address - Street 1:234 WILLARD STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32922-7984
Mailing Address - Country:US
Mailing Address - Phone:321-631-9014
Mailing Address - Fax:321-631-8010
Practice Address - Street 1:234 WILLARD ST
Practice Address - Street 2:SUITE A
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-7984
Practice Address - Country:US
Practice Address - Phone:321-631-9014
Practice Address - Fax:321-631-8010
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAMPART GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-20
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9030311500000X
261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL675597600Medicaid