1639193832 NPI number — REHABILITATION INNOVATIONS,INC

Table of content: (NPI 1639193832)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639193832 NPI number — REHABILITATION INNOVATIONS,INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REHABILITATION INNOVATIONS,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:
1639193832
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2501 LEECHBURG RD
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
LOWER BURRELL
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15068-3060
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-304-0030
Provider Business Mailing Address Fax Number:
724-304-0035

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2501 LEECHBURG RD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
LOWER BURRELL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15068-3060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-304-0030
Provider Business Practice Location Address Fax Number:
724-304-0035
Provider Enumeration Date:
07/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GWINN
Authorized Official First Name:
SHARON
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
724-304-0030

Provider Taxonomy Codes

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

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

  • Identifier: 237320 . This is a "HEALTH AMERICA GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7741595 . This is a "AETNA PPO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3446732 . This is a "AETNA HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 01946729 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2114944 . This is a "FIRST HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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