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1093824831

NPI Code Detail

MEDICARE: COMMUNITY REHAB, INC

MEDICARE: COMMUNITY REHAB, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	N/A	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S561	OTHER	NE	MIDLANDS CHOICE
2	83270	OTHER	NE	COVENTRY
3	193153204	OTHER	NE	DOL-OWCP
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	01805	OTHER	NE	BLUE CROSS BLUE SHIELD
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093824831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY REHAB, INC

Provider Business Mailing Address
First Line	:	1103 GALVIN ROAD SOUTH AREA A
Second Line	:
City	:	BELLEVUE
State	:	NE
Zip	:	68005
Country	:	US
Telephone Number	:	402-408-0890
Fax Number	:	402-408-0892

Provider Business Practice Location Address
First Line	:	1103 GALVIN RD SOUTH AREA A
Second Line	:
City	:	BELLEVUE
State	:	NE
Zip	:	68005-3002
Country	:	US
Telephone Number	:	402-408-0890
Fax Number	:	402-408-0892

Authorized Official
Title or Position	:	OWNER/PHYSICAL THERAPIST
Name	:	MARY J THEILER
Credential	:	MPT
Telephone Number	:	402-721-3908

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	05/16/2008

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Directions to “COMMUNITY REHAB, INC ” Practice Location

Language	Start Address	Practice Location

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