MEDICARE: REHAB MEDICAL, 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

General Provider Information

NPI Number	:	1992575641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHAB MEDICAL, LLC

Provider Business Mailing Address
First Line	:	3750 PRIORITY WAY SOUTH DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-3831
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8936 WESTERN WAY STE 5
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-8393
Country	:	US
Telephone Number	:	317-559-2034
Fax Number	:

Authorized Official
Title or Position	:	OFFICE IMPLEMENTATION COORDINATOR
Name	:	MARCEL WARREN
Credential	:
Telephone Number	:	317-559-2034

Provider Enumeration Date	:	01/04/2024
Last Update Date	:	01/04/2024

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