Provider Demographics
NPI:1386794659
Name:HIGHLAND RIM CARDIAC REHAB, LLC
Entity type:Organization
Organization Name:HIGHLAND RIM CARDIAC REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INVESTOR-SITE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:KILPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:931-455-1092
Mailing Address - Street 1:1330 CEDAR LN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-2283
Mailing Address - Country:US
Mailing Address - Phone:931-455-1092
Mailing Address - Fax:931-455-1082
Practice Address - Street 1:1330 CEDAR LN
Practice Address - Street 2:SUITE 200
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2283
Practice Address - Country:US
Practice Address - Phone:931-455-1092
Practice Address - Fax:931-455-1082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac Facilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3372490Medicaid
TN3372490Medicaid