1538556089 NPI number — REHABCARE GROUP EAST, LLC

Table of content: (NPI 1538556089)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538556089 NPI number — REHABCARE GROUP EAST, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REHABCARE GROUP EAST, 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:
REHABCARE
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:
1538556089
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/20/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13810 SHELDON RD
Provider Second Line Business Mailing Address:
C/O ARBOR TERRACE AT CITRUS PARK
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33626-3679
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-333-9996
Provider Business Mailing Address Fax Number:
813-616-8507

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13810 SHELDON RD
Provider Second Line Business Practice Location Address:
C/O ARBOR TERRACE AT CITRUS PARK
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-333-9996
Provider Business Practice Location Address Fax Number:
813-616-8507
Provider Enumeration Date:
04/22/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WEAVER
Authorized Official First Name:
MARILYN
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
ASSISTANT SECRETARY
Authorized Official Telephone Number:
502-596-7563

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)