MEDICARE: UNITED REHAB INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1114234754
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED REHAB INC.

Provider Business Mailing Address
First Line	:	1626 JEURGENS CT
Second Line	:
City	:	NORCROSS
State	:	GA
Zip	:	30093-2219
Country	:	US
Telephone Number	:	770-279-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 PANTHERSVILLE RD
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30034-3831
Country	:	US
Telephone Number	:	404-212-3400
Fax Number	:

Authorized Official
Title or Position	:	CHAIRMAN AND CEO
Name	:	NEIL L. PRUITT JR.
Credential	:
Telephone Number	:	770-279-6200

Provider Enumeration Date	:	09/02/2010
Last Update Date	:	09/02/2010

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