MEDICARE: TEAM REHAB, 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

Other Identifiers

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

General Provider Information

NPI Number	:	1710962469
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEAM REHAB, INC.

Provider Business Mailing Address
First Line	:	9450 N 107TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53224-1106
Country	:	US
Telephone Number	:	414-355-7157
Fax Number	:	414-355-7935

Provider Business Practice Location Address
First Line	:	9450 N 107TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53224-1106
Country	:	US
Telephone Number	:	414-355-7157
Fax Number	:	414-355-7935

Authorized Official
Title or Position	:	CFO
Name	:	MR. STEPHEN A MASSE'
Credential	:
Telephone Number	:	414-355-7157

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	08/22/2020

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