Healthcare Provider Details
I. General information
NPI: 1902205099
Provider Name (Legal Business Name): REHAB MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2014
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2866 DAUPHIN ST STE M
MOBILE AL
36606-2482
US
IV. Provider business mailing address
3750 PRIORITY WAY SOUTH DR
INDIANAPOLIS IN
46240-3831
US
V. Phone/Fax
- Phone: 317-813-0205
- Fax: 251-725-6204
- Phone: 317-436-6178
- Fax: 251-725-6204
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 1303 |
| License Number State | IN |
VIII. Authorized Official
Name: MR.
PATRICK
D
MCGINLEY
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 317-813-0205