=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205259470
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEW BEGINNINGS PULMONARY REHAB INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2014
-----------------------------------------------------
Last Update Date | 01/24/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 342 COEBURN AVE. SW
-----------------------------------------------------
City | NORTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24273
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-679-2969
-----------------------------------------------------
Fax | 276-679-2979
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 342 COEBURN AVE.
-----------------------------------------------------
City | NORTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24273
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-679-2969
-----------------------------------------------------
Fax | 276-679-2979
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MRS. MARCLINA TATE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 276-679-2969
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0400X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------