1376740225 NPI number — ADVANCED REHABILITATION MEDICINE LTD

Table of content: (NPI 1376740225)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376740225 NPI number — ADVANCED REHABILITATION MEDICINE LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED REHABILITATION MEDICINE LTD
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:
1376740225
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/15/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9634 MILLSFORD CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-8475
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-715-9317
Provider Business Mailing Address Fax Number:
615-721-4395

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 PHYSICIANS WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37067-1471
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-721-4026
Provider Business Practice Location Address Fax Number:
615-721-4395
Provider Enumeration Date:
07/02/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CRAIG
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
ALAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
630-338-7168

Provider Taxonomy Codes

  • Taxonomy code: 208100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10132121 . This is a "BCBS ID" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".