Healthcare Provider Details
I. General information
NPI: 1811233356
Provider Name (Legal Business Name): CHESAPEAKE REHAB EQUIPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/02/2013
Last Update Date: 09/21/2024
Certification Date: 09/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
608 GREEN TREE RD STE A
CHESAPEAKE VA
23320-3826
US
IV. Provider business mailing address
805 BROOK ST STE 402
ROCKY HILL CT
06067-3431
US
V. Phone/Fax
- Phone: 757-966-7964
- Fax: 757-966-7965
- Phone: 314-447-7500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TAMAS
JOHNSON
Title or Position: CFO
Credential:
Phone: 314-447-7515