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NPI Code Detail

MEDICARE: ROCKFORD HYPERBARIC HEALING CENTER, INC

MEDICARE: ROCKFORD HYPERBARIC HEALING CENTER, 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
1207PE0005XUndersea and Hyperbaric Medicine (Emergency Medicine) Physician

General Provider Information

NPI Number : 1790844959
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROCKFORD HYPERBARIC HEALING CENTER, INC
Provider Business Mailing Address
First Line : 4753 MANHATTAN DR
Second Line :
City : ROCKFORD
State : IL
Zip : 61108-2264
Country : US
Telephone Number : 815-395-1450
Fax Number : 815-395-1459
Provider Business Practice Location Address
First Line : 4753 MANHATTAN DR
Second Line :
City : ROCKFORD
State : IL
Zip : 61108-2264
Country : US
Telephone Number : 815-395-1450
Fax Number : 815-395-1459
Authorized Official
Title or Position : OWNER
Name : MR. JOSEPH SHARP
Credential :
Telephone Number : 815-395-1450
Provider Enumeration Date : 12/06/2006
Last Update Date : 12/03/2008

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