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General NPI Number Information
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NPI Number | 1225254857
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Entity Type | Organization
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Legal Business Name | MEDICAL HOME REHAB INC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 1751 AVIATION BLVD STE 150
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City | LINCOLN
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State | CA
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Zip | 95648-9687
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Country | US
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Telephone | 916-599-2019
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Fax |
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Provider Business Mailing Address
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Address Line | 1751 AVIATION BLVD STE 150
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City | LINCOLN
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State | CA
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Zip | 95648-9687
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE CHAIRMAN OF THE BOARD
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Name | JEREMY PERKINS
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Credential |
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Telephone | 916-599-2019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 55914
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License Number State | CA
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