1689051500 NPI number — SUBURBAN/NRH REHABILITATION HOSPITAL, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689051500 NPI number — SUBURBAN/NRH REHABILITATION HOSPITAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUBURBAN/NRH REHABILITATION HOSPITAL, 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:
6
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:
1689051500
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20401 CENTURY BLVD.
Provider Second Line Business Mailing Address:
SUITE 215
Provider Business Mailing Address City Name:
GERMANTOWN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20874-3701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-540-6140
Provider Business Mailing Address Fax Number:
301-540-5190

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1145 19TH ST., NW
Provider Second Line Business Practice Location Address:
SUITE 403
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-540-6140
Provider Business Practice Location Address Fax Number:
301-540-5190
Provider Enumeration Date:
04/29/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BRICKLEY
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT AMBULATORY OPERATION
Authorized Official Telephone Number:
301-540-6140

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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