1225152887 NPI number — GOODWIN REHAB ENTERPRISES, INC.

Table of content: MEGAN ANN WHEELER PHARMD (NPI 1629140348)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225152887 NPI number — GOODWIN REHAB ENTERPRISES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GOODWIN REHAB ENTERPRISES, 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:
PERSPECTIVES IN REHAB
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:
1225152887
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:
905 W MAIN ST
Provider Second Line Business Mailing Address:
SUITE G
Provider Business Mailing Address City Name:
EL CAJON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92020-3162
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-279-7701
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
905 W MAIN ST
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
EL CAJON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92020-3162
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-279-7701
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GOODWIN
Authorized Official First Name:
DONNELLA
Authorized Official Middle Name:
RENEE
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
619-279-7701

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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





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