Provider Demographics
NPI:1215042023
Name:REHAB MANAGEMENT OF MD, INC.
Entity Type:Organization
Organization Name:REHAB MANAGEMENT OF MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:T
Authorized Official - Last Name:BOTENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-379-9265
Mailing Address - Street 1:1 PARKWEST CIR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-5551
Mailing Address - Country:US
Mailing Address - Phone:804-379-9265
Mailing Address - Fax:804-379-9269
Practice Address - Street 1:8800 OLD HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-2867
Practice Address - Country:US
Practice Address - Phone:410-882-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
216686Medicare Oscar/Certification