Healthcare Provider Details

I. General information

NPI: 1033917232
Provider Name (Legal Business Name): TACTICAL REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 03/15/2026
Certification Date: 03/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PALOMAR AIRPORT RD STE 300
CARLSBAD CA
92011-1028
US

IV. Provider business mailing address

2040 WILMINGTON HWY STE A
JACKSONVILLE NC
28540-3191
US

V. Phone/Fax

Practice location:
  • Phone: 442-264-1870
  • Fax: 910-210-0791
Mailing address:
  • Phone: 910-210-0790
  • Fax: 910-210-0791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KATRINA GARCIA
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 772-275-4862