MEDICARE: COMPREHENSIVE REHAB OF WILSON, 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	1870	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0777Y	OTHER	NC	BCBS OF NC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861450884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE REHAB OF WILSON, INC.

Provider Business Mailing Address
First Line	:	1811 FOREST HILLS RD W
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893-3412
Country	:	US
Telephone Number	:	252-243-7400
Fax Number	:	252-243-3291

Provider Business Practice Location Address
First Line	:	1811 FOREST HILLS RD W
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893-3412
Country	:	US
Telephone Number	:	252-243-7400
Fax Number	:	252-243-3291

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	MS. EILEEN RODRI CARTER I
Credential	:	PT,DPT,MBA
Telephone Number	:	252-243-7400

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	03/16/2017

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