Provider Demographics
NPI:1316903123
Name:RPM REHAB, INC
Entity type:Organization
Organization Name:RPM REHAB, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-750-2067
Mailing Address - Street 1:330 FRANKLIN RD
Mailing Address - Street 2:STE 135A-102
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-3280
Mailing Address - Country:US
Mailing Address - Phone:760-256-2800
Mailing Address - Fax:760-256-2809
Practice Address - Street 1:1608 SOUTH 24TH AVE
Practice Address - Street 2:STE 102
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-5719
Practice Address - Country:US
Practice Address - Phone:509-248-6113
Practice Address - Fax:509-457-8941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003868225100000X
225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7087117Medicaid
WAAB04297Medicare ID - Type Unspecified