Healthcare Provider Details
I. General information
NPI: 1346410081
Provider Name (Legal Business Name): REHABTECH DME
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/10/2008
Last Update Date: 06/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
568 N INDIANA AVE
CROWN POINT IN
46307-3412
US
IV. Provider business mailing address
440 W BELL CT STE 400
OAK CREEK WI
53154-8335
US
V. Phone/Fax
- Phone: 219-663-0560
- Fax: 219-663-0552
- Phone: 414-762-1300
- Fax: 414-762-6484
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
REBECCA
L
TOGLIATTI
Title or Position: OWNER
Credential:
Phone: 414-762-1300