Provider Demographics
NPI:1932380409
Name:REHAB ENGINEERING LLC
Entity type:Organization
Organization Name:REHAB ENGINEERING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CPO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:R
Authorized Official - Last Name:FREDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:850-656-3599
Mailing Address - Street 1:789 SHERMAN RD
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:GA
Mailing Address - Zip Code:39828-8451
Mailing Address - Country:US
Mailing Address - Phone:850-656-3599
Mailing Address - Fax:850-769-2366
Practice Address - Street 1:1719 MAHAN DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5201
Practice Address - Country:US
Practice Address - Phone:850-656-3599
Practice Address - Fax:850-769-2366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPOR28332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5863580001Medicare NSC