1023013836 NPI number — HORNSBY REHABILITATION SERVICES LLC

Table of content: (NPI 1023013836)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023013836 NPI number — HORNSBY REHABILITATION SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HORNSBY REHABILITATION SERVICES LLC
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:
FYZICAL THERAPY & BALANCE CENTER
Provider Other Organization Name Type Code:
3
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:
1023013836
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9070 W CHEYENNE AVE STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89129-8935
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-818-5000
Provider Business Mailing Address Fax Number:
702-818-5001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
235 JIM BERRY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28734-8660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-369-7878
Provider Business Practice Location Address Fax Number:
828-369-8760
Provider Enumeration Date:
06/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
THOMPSON
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
Authorized Official Title or Position:
EVP, CFO
Authorized Official Telephone Number:
941-870-7090

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0796H . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7211277 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: CF8693 . This is a "RR MEDICARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com