Provider Demographics
NPI:1407430903
Name:REHAB RX LLC
Entity Type:Organization
Organization Name:REHAB RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IDYLLA
Authorized Official - Middle Name:
Authorized Official - Last Name:REALUBIT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:828-773-2105
Mailing Address - Street 1:4949 NATALIE WAY
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-1199
Mailing Address - Country:US
Mailing Address - Phone:828-773-2105
Mailing Address - Fax:
Practice Address - Street 1:4949 NATALIE WAY
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-1199
Practice Address - Country:US
Practice Address - Phone:828-773-2105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy