Provider Demographics
NPI:1992743363
Name:PROGRESSIVE HEALTH REHABILITATION, INC.
Entity type:Organization
Organization Name:PROGRESSIVE HEALTH REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORP. DIR. OF REIMBURSEMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:RAELYNN
Authorized Official - Last Name:GEORGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-476-7000
Mailing Address - Street 1:PO BOX 6890
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47719-0890
Mailing Address - Country:US
Mailing Address - Phone:812-476-7000
Mailing Address - Fax:812-476-2446
Practice Address - Street 1:150 N ROSENBERGER AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-6503
Practice Address - Country:US
Practice Address - Phone:812-476-7000
Practice Address - Fax:812-476-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN156574Medicare ID - Type UnspecifiedMEDICARE