=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053580290
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SALISBURY HAND REHABILTATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/21/2008
-----------------------------------------------------
Last Update Date | 06/23/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1344 S DIVISION ST SUITE 201
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21804-7096
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-749-6760
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1344 S DIVISION ST SUITE 201
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21804-7096
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-749-6760
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/DIRECTOR
-----------------------------------------------------
Name | MRS. REGINA ANN BEATUS
-----------------------------------------------------
Credential | M.A., P.T., C.H.T
-----------------------------------------------------
Telephone | 410-749-6760
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BC3200X
-----------------------------------------------------
Taxonomy Name | Customized Equipment (DME)
-----------------------------------------------------
License Number | 15397
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 15397
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------