=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619331683
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REHABMED H AND H LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2016
-----------------------------------------------------
Last Update Date | 04/06/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 998 S DORSET RD SUITE 104
-----------------------------------------------------
City | TROY
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45373-4753
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-332-8843
-----------------------------------------------------
Fax | 937-332-8982
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 998 S DORSET RD SUITE 104
-----------------------------------------------------
City | TROY
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45373-4753
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-332-8843
-----------------------------------------------------
Fax | 937-332-8982
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. JAMES B HOOVER
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 937-332-8843
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | 35048004
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------