Healthcare Provider Details

I. General information

NPI: 1851601363
Provider Name (Legal Business Name): REHOBOTH MEDICAL TRANSPORTATION AND EQUIPMENT SALES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2010
Last Update Date: 07/21/2022
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 W EXCHANGE ST
CRETE IL
60417-2003
US

IV. Provider business mailing address

575 W EXCHANGE ST
CRETE IL
60417-2003
US

V. Phone/Fax

Practice location:
  • Phone: 708-279-7879
  • Fax: 708-880-0702
Mailing address:
  • Phone: 708-279-7879
  • Fax: 708-880-0702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number001
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number001
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number001
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number001
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number001
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number001
License Number StateIL

VIII. Authorized Official

Name: MR. ADEKANMI AROJOJOYE
Title or Position: PRESIDENT
Credential:
Phone: 312-217-5591