Provider Demographics
NPI:1366624223
Name:INDEPENDENCE REHAB EQUIPMENT INC
Entity Type:Organization
Organization Name:INDEPENDENCE REHAB EQUIPMENT INC
Other - Org Name:INDEPENDENCE REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HEALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-832-9770
Mailing Address - Street 1:8844 TRADEWAY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-6115
Mailing Address - Country:US
Mailing Address - Phone:210-832-9770
Mailing Address - Fax:210-832-0010
Practice Address - Street 1:8844 TRADEWAY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6115
Practice Address - Country:US
Practice Address - Phone:210-832-9770
Practice Address - Fax:210-832-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0098372332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment