Provider Demographics
NPI:1164790630
Name:PREMIER REHAB MANAGEMENT, LLC
Entity Type:Organization
Organization Name:PREMIER REHAB MANAGEMENT, LLC
Other - Org Name:PT SOLUTIONS
Other - Org Type:Doing Business As
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 441146
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30160-9522
Mailing Address - Country:US
Mailing Address - Phone:770-917-1395
Mailing Address - Fax:770-423-3369
Practice Address - Street 1:249 MACK BAYOU LOOP
Practice Address - Street 2:STE 101
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-7198
Practice Address - Country:US
Practice Address - Phone:678-932-3629
Practice Address - Fax:770-423-3369
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER REHAB MANAGEMENT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-12
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty