Basic Information
| Provider Information | |||||||||
| NPI: | 1114197175 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RAUCH INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 845 PARK PL | ||||||||
| Address2: | |||||||||
| City: | NEW ALBANY | ||||||||
| State: | IN | ||||||||
| PostalCode: | 471502262 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8129454063 | ||||||||
| FaxNumber: | 8129418820 | ||||||||
| Practice Location | |||||||||
| Address1: | 2525 CHARLESTOWN RD | ||||||||
| Address2: | |||||||||
| City: | NEW ALBANY | ||||||||
| State: | IN | ||||||||
| PostalCode: | 471502556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8129454063 | ||||||||
| FaxNumber: | 8129415239 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2008 | ||||||||
| LastUpdateDate: | 12/03/2010 | ||||||||
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| AuthorizedOfficialLastName: | DUNHAM | ||||||||
| AuthorizedOfficialFirstName: | BETTYE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 8129454063 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 31003497A | IN | N | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 252Y00000X | Y | Agencies | Early Intervention Provider Agency |
No ID Information.