MEDICARE: REHAB & INDUSTRIAL SERVICES

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	305R00000X	Preferred Provider Organization

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	:	1801118351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHAB & INDUSTRIAL SERVICES

Provider Business Mailing Address
First Line	:	325 HANSON ST
Second Line	:
City	:	WINNEMUCCA
State	:	NV
Zip	:	89445-3607
Country	:	US
Telephone Number	:	775-748-2086
Fax Number	:	775-748-2087

Provider Business Practice Location Address
First Line	:	925 NORTH WELLS AVENUE
Second Line	:	UNIT B
City	:	WEST WENDOVER
State	:	NV
Zip	:	89883
Country	:	US
Telephone Number	:	775-664-4144
Fax Number	:	775-664-4141

Authorized Official
Title or Position	:	OFFICE CREDENTIALER
Name	:	DANA L TUCKER
Credential	:
Telephone Number	:	775-748-2086

Provider Enumeration Date	:	02/25/2010
Last Update Date	:	02/25/2010

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