MEDICARE: REHAB ONE MEDICAL SUPPLY, LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1316493059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHAB ONE MEDICAL SUPPLY, LLC

Provider Business Mailing Address
First Line	:	22720 MICHIGAN AVE STE 100B
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-2035
Country	:	US
Telephone Number	:	313-565-2224
Fax Number	:

Provider Business Practice Location Address
First Line	:	22720 MICHIGAN AVE STE 100B
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-2035
Country	:	US
Telephone Number	:	313-565-2224
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HAANEI SHWEHDI
Credential	:
Telephone Number	:	313-565-2224

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	05/20/2022

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