1316052145 NPI number — REHAB MANAGEMENT OF PA, INC.

Table of content: (NPI 1316052145)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316052145 NPI number — REHAB MANAGEMENT OF PA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REHAB MANAGEMENT OF PA, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316052145
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 PARKWEST CIR
Provider Second Line Business Mailing Address:
SUITE 108
Provider Business Mailing Address City Name:
MIDLOTHIAN
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23114-5551
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-379-9265
Provider Business Mailing Address Fax Number:
804-379-9269

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1730 BUCK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FEASTERVILLE TREVOSE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19053-2251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-355-3131
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BOTENS
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
T
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
804-379-9265

Provider Taxonomy Codes

  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)