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	1003819608	OTHER	AL	GROUP NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487932471
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	:	5291 VALLEYDALE RD
Second Line	:	SUITE 113
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-7705
Country	:	US
Telephone Number	:	205-408-4123
Fax Number	:	205-408-4189

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

Provider Enumeration Date	:	07/26/2011
Last Update Date	:	12/02/2020

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