Healthcare Provider Details

I. General information

NPI: 1598734352
Provider Name (Legal Business Name): REBOUND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 08/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 MOUNT PELIA RD
MARTIN TN
38237-3812
US

IV. Provider business mailing address

190 MOUNT PELIA RD
MARTIN TN
38237-3812
US

V. Phone/Fax

Practice location:
  • Phone: 731-587-4231
  • Fax: 731-587-6716
Mailing address:
  • Phone: 731-587-4231
  • Fax: 731-587-6716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROBIN SAYWARD
Title or Position: IP BUSINESS OPERATIONS
Credential:
Phone: 954-713-6165