Healthcare Provider Details
I. General information
NPI: 1952442063
Provider Name (Legal Business Name): RIPPEE REHAB INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/09/2007
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5134 STAGE RD SUITE 100
MEMPHIS TN
38134-3153
US
IV. Provider business mailing address
5134 STAGE RD SUITE 100
MEMPHIS TN
38134-3153
US
V. Phone/Fax
- Phone: 901-412-4516
- Fax: 901-388-9399
- Phone: 901-388-4444
- Fax: 901-388-9399
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 305R00000X |
| Taxonomy | Preferred Provider Organization |
| License Number | CRT3018 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0401X |
| Taxonomy | Comprehensive Outpatient Rehabilitation Facility (CORF) |
| License Number | CRT318 |
| License Number State | TN |
VIII. Authorized Official
Name: MS.
TERESA
RIPPEE
Title or Position: OWNER
Credential: RRT
Phone: 901-388-4444