Provider Demographics
NPI:1396817821
Name:REABILITY MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:REABILITY MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:DEANN
Authorized Official - Last Name:RACE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, GCS
Authorized Official - Phone:580-931-3131
Mailing Address - Street 1:2912 ENTERPRISE DR
Mailing Address - Street 2:SUITE B1
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-1963
Mailing Address - Country:US
Mailing Address - Phone:580-931-3131
Mailing Address - Fax:580-745-9467
Practice Address - Street 1:2912 ENTERPRISE DR
Practice Address - Street 2:SUITE B1
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-1963
Practice Address - Country:US
Practice Address - Phone:580-931-3131
Practice Address - Fax:580-745-9467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT 2356332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK5810740001Medicare ID - Type Unspecified