Healthcare Provider Details

I. General information

NPI: 1578232377
Provider Name (Legal Business Name): REHABTECH SUPPLY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 WELDON PKWY
MARYLAND HEIGHTS MO
63043-3103
US

IV. Provider business mailing address

655 W GRAND AVE STE 100
ELMHURST IL
60126-1061
US

V. Phone/Fax

Practice location:
  • Phone: 888-800-9445
  • Fax:
Mailing address:
  • Phone: 888-800-9445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: BRIAN DACY
Title or Position: PRESIDENT
Credential:
Phone: 888-800-9445