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NPI Code Detail

MEDICARE: H2 REHABILITATION SERVICES OF KENTUCKY, LLC

MEDICARE: H2 REHABILITATION SERVICES OF KENTUCKY, 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
1261QR0400XRehabilitation Clinic/Center000459KY

General Provider Information

NPI Number : 1942434345
Entity Type Code : Organization
Provider Name (Legal Business Name) : H2 REHABILITATION SERVICES OF KENTUCKY, LLC
Provider Business Mailing Address
First Line : PO BOX 932184
Second Line :
City : ATLANTA
State : GA
Zip : 31193-2184
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1704 W STOCKTON ST
Second Line : SUITE A
City : EDMONTON
State : KY
Zip : 42129-8137
Country : US
Telephone Number : 270-432-3200
Fax Number : 270-433-2320
Authorized Official
Title or Position : VICE PRESIDENT
Name : AMANDA STREETER
Credential :
Telephone Number : 800-699-9395
Provider Enumeration Date : 05/13/2009
Last Update Date : 11/24/2023

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