=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851320774
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REHAB MEDICAL OF COLUMBUS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/02/2006
-----------------------------------------------------
Last Update Date | 10/25/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 510 E WILSON BRIDGE RD STE A
-----------------------------------------------------
City | WORTHINGTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43085-2373
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-430-8936
-----------------------------------------------------
Fax | 614-430-8514
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3750 PRIORITY WAY SOUTH DR
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46240-3831
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-436-6178
-----------------------------------------------------
Fax | 317-436-6178
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | KEVIN GEARHEART
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 317-813-4210
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 200535002134
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------