Provider Demographics
NPI:1427376193
Name:GENUINE CARE REHABILITATION SERVICE INC.
Entity Type:Organization
Organization Name:GENUINE CARE REHABILITATION SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:CP, LPO, FAAOP
Authorized Official - Phone:405-842-8505
Mailing Address - Street 1:7510 BROADWAY EXT
Mailing Address - Street 2:SUITE 204
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-9031
Mailing Address - Country:US
Mailing Address - Phone:405-842-8505
Mailing Address - Fax:405-842-8805
Practice Address - Street 1:7510 BROADWAY EXT
Practice Address - Street 2:SUITE 204
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-9031
Practice Address - Country:US
Practice Address - Phone:405-842-8505
Practice Address - Fax:405-842-8805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK42332BC3200X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1095400001Medicare NSC