MEDICARE: TACTICAL REHABILITATION INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332BC3200X	Customized Equipment (DME)
2	225000000X	Orthotic Fitter
3	332BX2000X	Oxygen Equipment & Supplies (DME)
4	335E00000X	Prosthetic/Orthotic Supplier
5	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1235764473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TACTICAL REHABILITATION INC

Provider Business Mailing Address
First Line	:	PO BOX 1306
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28541-1306
Country	:	US
Telephone Number	:	423-262-9720
Fax Number	:

Provider Business Practice Location Address
First Line	:	15110 UNION AVE SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98498-2093
Country	:	US
Telephone Number	:	360-406-4891
Fax Number	:	910-210-0791

Authorized Official
Title or Position	:	CFO
Name	:	KAREN C LYONS
Credential	:
Telephone Number	:	423-262-9720

Provider Enumeration Date	:	03/09/2020
Last Update Date	:	03/15/2026

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Directions to “TACTICAL REHABILITATION INC ” Practice Location

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