Provider Demographics
NPI:1992216394
Name:RIO FAMILY HEALTHCARE LLC
Entity type:Organization
Organization Name:RIO FAMILY HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:740-645-3620
Mailing Address - Street 1:PO BOX 318
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:OH
Mailing Address - Zip Code:45674-0318
Mailing Address - Country:US
Mailing Address - Phone:740-645-3620
Mailing Address - Fax:
Practice Address - Street 1:100 SR 325 SOUTH
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:OH
Practice Address - Zip Code:45674
Practice Address - Country:US
Practice Address - Phone:740-245-0033
Practice Address - Fax:740-245-0031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12484261QP2300X, 363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty