MEDICARE: ENCORE REHABILITATION, 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	261QP2000X	Physical Therapy Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1003819608	OTHER	AL	GROUP NPI

General Provider Information

NPI Number	:	1437588845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENCORE REHABILITATION, INC.

Provider Business Mailing Address
First Line	:	251 JOHNSTON ST SE
Second Line	:	SUITE 300
City	:	DECATUR
State	:	AL
Zip	:	35601-2515
Country	:	US
Telephone Number	:	256-340-9708
Fax Number	:	256-340-9624

Provider Business Practice Location Address
First Line	:	124 EDWINA ST
Second Line	:
City	:	EVERGREEN
State	:	AL
Zip	:	36401-3319
Country	:	US
Telephone Number	:	251-216-5118
Fax Number	:	251-216-5120

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PAUL HENDERSON
Credential	:
Telephone Number	:	256-350-1764

Provider Enumeration Date	:	11/06/2013
Last Update Date	:	12/02/2020

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