MEDICARE: TACTICAL REHABILITATION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332BC3200X	Customized Equipment (DME)
2	225000000X	Orthotic Fitter
3	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1598654899
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TACTICAL REHABILITATION, INC.

Provider Business Mailing Address
First Line	:	2040 WILMINGTON HWY STE A
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-3191
Country	:	US
Telephone Number	:	423-262-9720
Fax Number	:

Provider Business Practice Location Address
First Line	:	6760 CORPORATE DR FL 1
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-1985
Country	:	US
Telephone Number	:	910-210-0790
Fax Number	:	910-210-0791

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	KAREN C LYONS
Credential	:
Telephone Number	:	423-262-9720

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	03/15/2026

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