Basic Information
Provider Information
NPI: 1245876275
EntityType: 2
ReplacementNPI:  
OrganizationName: REHAB ASSOCIATES, LLC
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Mailing Information
Address1: 4714 GETTYSBURG RD
Address2:  
City: MECHANICSBURG
State: PA
PostalCode: 170554325
CountryCode: US
TelephoneNumber: 7179721100
FaxNumber:  
Practice Location
Address1: 1021 MONTGOMERY HWY STE 200
Address2:  
City: VESTAVIA HILLS
State: AL
PostalCode: 352162805
CountryCode: US
TelephoneNumber: 2058826990
FaxNumber: 2058825662
Other Information
ProviderEnumerationDate: 11/25/2019
LastUpdateDate: 05/26/2020
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: TARVIN
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName: E
AuthorizedOfficialTitleorPosition: VICE PRESIDENT
AuthorizedOfficialTelephone: 7179721100
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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NPICertificationDate: 05/26/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QR0400X  Y Ambulatory Health Care FacilitiesClinic/CenterRehabilitation

No ID Information.


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