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NPI Code Detail

MEDICARE: REDIMED DEKALB LLC

MEDICARE: REDIMED DEKALB 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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1467549725
Entity Type Code : Organization
Provider Name (Legal Business Name) : REDIMED DEKALB LLC
Provider Business Mailing Address
First Line : 7100 COMMERCE WAY
Second Line : SUITE 180
City : BRENTWOOD
State : TN
Zip : 37027-2851
Country : US
Telephone Number : 615-465-7000
Fax Number : 615-465-3007
Provider Business Practice Location Address
First Line : 1316 E. 7TH ST
Second Line :
City : AUBURN
State : IN
Zip : 46706-2523
Country : US
Telephone Number : 260-925-9511
Fax Number : 260-925-7626
Authorized Official
Title or Position : DIRECTOR OF PROVIDER ENROLLMENT
Name : DEBBIE T BREWER
Credential :
Telephone Number : 877-892-9813
Provider Enumeration Date : 10/06/2006
Last Update Date : 03/25/2009

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Directions to “REDIMED DEKALB LLC ” Practice Location

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