1578667812 NPI number — REHABPLUS, P.C.

Table of content: (NPI 1578667812)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578667812 NPI number — REHABPLUS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REHABPLUS, P.C.
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:
1578667812
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4969 HAMILTON BLVD
Provider Second Line Business Mailing Address:
UNIT 1
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18106-9729
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-821-1044
Provider Business Mailing Address Fax Number:
610-821-1045

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4969 HAMILTON BLVD
Provider Second Line Business Practice Location Address:
UNIT 1
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18106-9729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-821-1044
Provider Business Practice Location Address Fax Number:
610-821-1045
Provider Enumeration Date:
09/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MANION
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
PAUL
Authorized Official Title or Position:
OWNER/PRESIDENT/CHIROPRACTOR
Authorized Official Telephone Number:
610-821-1044

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC006629L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8337168 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 849712 . This is a "BC/BS" identifier . This identifiers is of the category "OTHER".




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