MEDICARE: RCI (WRS), LLC.

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	:	1255945317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RCI (WRS), LLC.

Provider Business Mailing Address
First Line	:	4714 GETTYSBURG RD
Second Line	:
City	:	MECHANICSBURG
State	:	PA
Zip	:	17055-4325
Country	:	US
Telephone Number	:	717-972-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1751 W DIVISION ST UNIT C-1E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-4086
Country	:	US
Telephone Number	:	773-278-9050
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MICHAEL TARVIN
Credential	:
Telephone Number	:	717-972-1100

Provider Enumeration Date	:	09/04/2020
Last Update Date	:	09/21/2020

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