1265605224 NPI number — REHABILITATION MANAGEMENT SPECIALISTS, LLC

Table of content: (NPI 1265605224)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265605224 NPI number — REHABILITATION MANAGEMENT SPECIALISTS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REHABILITATION MANAGEMENT SPECIALISTS, 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:
QUEST REHAB AND WELLNESS
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:
1265605224
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3805 NAZARETH PIKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18020-1140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-821-0346
Provider Business Mailing Address Fax Number:
484-821-0359

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3805 NAZARETH PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18020-1140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-821-0346
Provider Business Practice Location Address Fax Number:
484-821-0359
Provider Enumeration Date:
04/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
REYES
Authorized Official First Name:
DANNIELL
Authorized Official Middle Name:
JESUS
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
484-821-0232

Provider Taxonomy Codes

  • Taxonomy code: 2081P2900X , with the licence number:  DC-006207-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1146297 . This is a "AMERIHEALTH MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2141296000 . This is a "IND. BC/BS GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3000378 . This is a "KHPC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 265170001 . This is a "KEYSTONE EAST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1445656 . This is a "HIGHMARK BCARD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0265170000 . This is a "IND. BC/BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 02754900 . This is a "KHPC GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2141296000 . This is a "KEYSTONE EAST GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7957156 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 506314 . This is a "AMERIHEALTH ADMIN." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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