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NPI Code Detail

MEDICARE: EDGEFIELD REHABILITATION, LLC

MEDICARE: EDGEFIELD REHABILITATION, 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
1282N00000XGeneral Acute Care Hospital34TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669469805
Entity Type Code : Organization
Provider Name (Legal Business Name) : EDGEFIELD REHABILITATION, LLC
Provider Business Mailing Address
First Line : 610 GALLATIN AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37206-3225
Country : US
Telephone Number : 615-226-4330
Fax Number : 615-650-2565
Provider Business Practice Location Address
First Line : 610 GALLATIN AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37206-3225
Country : US
Telephone Number : 615-226-4330
Fax Number : 615-650-2565
Authorized Official
Title or Position : CEO/MEDICAL DIRECTOR
Name : MR. BARTON HUDDLESTON
Credential : M.D.
Telephone Number : 615-226-4330
Provider Enumeration Date : 10/03/2005
Last Update Date : 08/22/2020

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Directions to “EDGEFIELD REHABILITATION, LLC ” Practice Location

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