Provider Demographics
NPI:1487088837
Name:PREMIER REHAB MANAGEMENT, LLC
Entity type:Organization
Organization Name:PREMIER REHAB MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILPOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-403-3568
Mailing Address - Street 1:PO BOX 242037
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-2037
Mailing Address - Country:US
Mailing Address - Phone:334-396-3273
Mailing Address - Fax:334-396-4905
Practice Address - Street 1:202 MARINA DR
Practice Address - Street 2:SUITE 302
Practice Address - City:PORT ST JOE
Practice Address - State:FL
Practice Address - Zip Code:32456-1832
Practice Address - Country:US
Practice Address - Phone:866-464-3878
Practice Address - Fax:334-396-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty