Provider Demographics
NPI:1326153479
Name:GEORGIA REHAB SERVICES, INC.
Entity Type:Organization
Organization Name:GEORGIA REHAB SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:RATHOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-784-0091
Mailing Address - Street 1:555 S MISSION ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2846
Mailing Address - Country:US
Mailing Address - Phone:989-772-5800
Mailing Address - Fax:989-772-4342
Practice Address - Street 1:5109 HIGHWAY 278 NE
Practice Address - Street 2:SUITE # C
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2608
Practice Address - Country:US
Practice Address - Phone:770-784-0091
Practice Address - Fax:770-784-0092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA116860Medicare Oscar/Certification