Provider Demographics
NPI:1033432778
Name:CENTER FOR REHABILITATION AND PAIN MANAGEMENT, LLC
Entity Type:Organization
Organization Name:CENTER FOR REHABILITATION AND PAIN MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAVNEET
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-284-0470
Mailing Address - Street 1:213 E BUTLER RD STE F1
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-2172
Mailing Address - Country:US
Mailing Address - Phone:864-284-0470
Mailing Address - Fax:864-284-0471
Practice Address - Street 1:213 E BUTLER RD
Practice Address - Street 2:UNIT F1
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-2171
Practice Address - Country:US
Practice Address - Phone:864-284-0470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27306261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty