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NPI Code Detail

MEDICARE: SERC REHABILITATION PARTNERS LLC

MEDICARE: SERC REHABILITATION PARTNERS 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
1261QM1300XMulti-Specialty Clinic/Center
2261QR0400XRehabilitation Clinic/Center
3261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1861823403
Entity Type Code : Organization
Provider Name (Legal Business Name) : SERC REHABILITATION PARTNERS LLC
Provider Business Mailing Address
First Line : 8823 PRODUCTION LN
Second Line :
City : OOLTEWAH
State : TN
Zip : 37363-6511
Country : US
Telephone Number : 423-238-7217
Fax Number : 423-238-3473
Provider Business Practice Location Address
First Line : 3627 SE 29TH ST
Second Line : STE 107
City : TOPEKA
State : KS
Zip : 66605-2013
Country : US
Telephone Number : 785-266-4600
Fax Number : 785-266-4601
Authorized Official
Title or Position : VP REVENUE CYCLE OPERATIONS
Name : KEVIN JOHANNESON
Credential :
Telephone Number : 423-238-7217
Provider Enumeration Date : 12/09/2013
Last Update Date : 04/26/2016

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Directions to “SERC REHABILITATION PARTNERS LLC ” Practice Location

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