MEDICARE: INPATIENT REHABILITATION GROUP INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207P00000X	Emergency Medicine Physician
2	207Q00000X	Family Medicine Physician
3	207R00000X	Internal Medicine Physician
4	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1619993797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INPATIENT REHABILITATION GROUP INC

Provider Business Mailing Address
First Line	:	6525 WEST CAMPUS OVAL
Second Line	:	STE 150
City	:	NEW ALBANY
State	:	OH
Zip	:	43054
Country	:	US
Telephone Number	:	614-433-9200
Fax Number	:	614-433-9201

Provider Business Practice Location Address
First Line	:	349 OLDE RIDENOUR RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43230-2528
Country	:	US
Telephone Number	:	614-433-9200
Fax Number	:	614-433-9201

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	NINO DIIULLO
Credential	:	MD
Telephone Number	:	614-433-9200

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	09/25/2008

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