MEDICARE: HART REHAB SPECIALISTS 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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	540B515220	OTHER	MI	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356406979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HART REHAB SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	PO BOX 831
Second Line	:
City	:	GRAND BLANC
State	:	MI
Zip	:	48480-0831
Country	:	US
Telephone Number	:	810-953-0760
Fax Number	:	810-953-0833

Provider Business Practice Location Address
First Line	:	3033 GRAND BLANC RD
Second Line	:
City	:	GRAND BLANC
State	:	MI
Zip	:	48439
Country	:	US
Telephone Number	:	810-953-0760
Fax Number	:	810-953-0833

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. TIMOTHY J HART
Credential	:
Telephone Number	:	810-953-0760

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	03/15/2011

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