1265821458 NPI number — COMPREHENSIVE MEDICAL REHABILITATION PC

Table of content: (NPI 1265821458)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265821458 NPI number — COMPREHENSIVE MEDICAL REHABILITATION PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPREHENSIVE MEDICAL REHABILITATION PC
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:
1265821458
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5705
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EVANSVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47716-5705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-492-1960
Provider Business Mailing Address Fax Number:
812-479-7865

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9355 WARRICK TRL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWBURGH
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47630-0015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-476-9983
Provider Business Practice Location Address Fax Number:
812-476-4270
Provider Enumeration Date:
01/12/2015

Additional Information

Authorized Official

Authorized Official Last Name:
DHINGRA
Authorized Official First Name:
ASHOK
Authorized Official Middle Name:
K
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
812-476-9983

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  01041108A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com