1437242245 NPI number — RHODES PHYSICAL THERAPY INC

Table of content: (NPI 1437242245)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437242245 NPI number — RHODES PHYSICAL THERAPY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RHODES PHYSICAL THERAPY 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:
1437242245
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 250
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLAIRSVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30514-0250
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-745-7481
Provider Business Mailing Address Fax Number:
706-745-7548

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
226 GAINESVILLE HWY
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
BLAIRSVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30512-4576
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-745-7481
Provider Business Practice Location Address Fax Number:
706-745-7548
Provider Enumeration Date:
10/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RHODES
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
F.
Authorized Official Title or Position:
OWNER/ADMINISTRATOR
Authorized Official Telephone Number:
706-745-7481

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  PT003720 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 9283109 . This is a "PHCS" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: A134524 . This is a "MULTI PLAN NETWORK" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 52355423 . This is a "BCBSGA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 5466818 . This is a "FIRST HEALTH NETWORK" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 611181900 . This is a "DOL OWCP" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




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