MEDICARE: REHAB SUPPLY 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
1	332B00000X	Durable Medical Equipment & Medical Supplies		NY

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
2	1215958202	OTHER		NPI

General Provider Information

NPI Number	:	1881929628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHAB SUPPLY LLC

Provider Business Mailing Address
First Line	:	17 CHARLES ST
Second Line	:
City	:	BINGHAMTON
State	:	NY
Zip	:	13905-2272
Country	:	US
Telephone Number	:	607-584-5560
Fax Number	:	607-584-5561

Provider Business Practice Location Address
First Line	:	341 WYOMING AVE STE 1
Second Line	:
City	:	WEST PITTSTON
State	:	PA
Zip	:	18643-2839
Country	:	US
Telephone Number	:	570-602-1069
Fax Number	:	570-602-1069

Authorized Official
Title or Position	:	OWNER/MANAGING EMPLOYEE
Name	:	MR. MICHAEL D BULMAN
Credential	:
Telephone Number	:	607-584-5560

Provider Enumeration Date	:	10/13/2009
Last Update Date	:	10/05/2010

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Directions to “REHAB SUPPLY LLC ” Practice Location

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