Provider Demographics
NPI:1083992077
Name:PREFERRED REHAB AND MOBILITY, LLC
Entity Type:Organization
Organization Name:PREFERRED REHAB AND MOBILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:HINTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-232-0997
Mailing Address - Street 1:160A KERNS AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-4372
Mailing Address - Country:US
Mailing Address - Phone:864-232-0997
Mailing Address - Fax:864-232-7889
Practice Address - Street 1:160A KERNS AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-4372
Practice Address - Country:US
Practice Address - Phone:864-232-0997
Practice Address - Fax:864-232-7889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC271704183Medicaid