Healthcare Provider Details

I. General information

NPI: 1326843020
Provider Name (Legal Business Name): REHAB MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 INTERSTATE DR STE Q
RICHLAND MS
39218-9458
US

IV. Provider business mailing address

3750 PRIORITY WAY SOUTH DR
INDIANAPOLIS IN
46240-3831
US

V. Phone/Fax

Practice location:
  • Phone: 251-725-6005
  • Fax:
Mailing address:
  • Phone: 317-436-6178
  • Fax: 855-671-9194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: KEVIN GEARHEART
Title or Position: PRESIDENT
Credential:
Phone: 317-813-4210