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General NPI Number Information
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NPI Number | 1336072867
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Entity Type | Organization
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Legal Business Name | TACTICAL REHABILITATION, INC.
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Dates
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Enumeration Date | 06/04/2026
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Last Update Date | 06/04/2026
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Provider Practice Location Address
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Address Line | 2305 HISTORIC DECATUR RD STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92106-6071
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Country | US
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Telephone | 423-278-9023
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Fax |
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Provider Business Mailing Address
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Address Line | 2040 WILMINGTON HWY STE A
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City | JACKSONVILLE
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State | NC
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Zip | 28540-3191
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Country | US
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Telephone | 423-278-9023
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | OSCAR MULLINAX JR.
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Credential |
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Telephone | 423-278-9023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225000000X
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Taxonomy Name | Orthotic Fitter
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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 | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #5
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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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