Provider Demographics
NPI:1316493059
Name:REHAB ONE MEDICAL SUPPLY, LLC
Entity type:Organization
Organization Name:REHAB ONE MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAANEI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHWEHDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-565-2224
Mailing Address - Street 1:22720 MICHIGAN AVE STE 100B
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2035
Mailing Address - Country:US
Mailing Address - Phone:313-565-2224
Mailing Address - Fax:
Practice Address - Street 1:22720 MICHIGAN AVE STE 100B
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2035
Practice Address - Country:US
Practice Address - Phone:313-565-2224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies