Healthcare Provider Details

I. General information

NPI: 1649244583
Provider Name (Legal Business Name): RUSK REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 BUSINESS LOOP 70 W
COLUMBIA MO
65203-3248
US

IV. Provider business mailing address

9001 LIBERTY PKWY
BIRMINGHAM AL
35242-7509
US

V. Phone/Fax

Practice location:
  • Phone: 573-817-2703
  • Fax: 573-817-4659
Mailing address:
  • Phone: 205-967-7116
  • Fax: 205-969-6650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number433-5
License Number StateMO

VIII. Authorized Official

Name: ROBERT W MCCALLUM
Title or Position: VICE PRESIDENT
Credential:
Phone: 205-970-5669