MEDICARE: ADVANCED REHAB TECHNOLOGIES, 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BC3200X	Customized Equipment (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	33217	OTHER	IA	WELLMARK BLUE CROSS BLUE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598769127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED REHAB TECHNOLOGIES, INC.

Provider Business Mailing Address
First Line	:	9245 N MERIDIAN ST
Second Line	:	SUITE 200
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-1836
Country	:	US
Telephone Number	:	317-333-6033
Fax Number	:	317-333-6034

Provider Business Practice Location Address
First Line	:	3936 NW URBANDALE DR
Second Line	:
City	:	URBANDALE
State	:	IA
Zip	:	50322-7922
Country	:	US
Telephone Number	:	515-270-1522
Fax Number	:	515-270-4914

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DAVID A HARTLEY JR.
Credential	:
Telephone Number	:	317-333-6033

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	02/27/2012

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