Provider Demographics
NPI:1497166920
Name:REHAB MEDICAL LLC
Entity Type:Organization
Organization Name:REHAB MEDICAL LLC
Other - Org Name:REHAB MEDICAL, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEARHEART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-813-4210
Mailing Address - Street 1:3750 PRIORITY WAY SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-3831
Mailing Address - Country:US
Mailing Address - Phone:850-791-6399
Mailing Address - Fax:850-791-6693
Practice Address - Street 1:4811 N PALAFOX ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32505-2907
Practice Address - Country:US
Practice Address - Phone:850-791-6399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REHAB MEDICAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-19
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1313917332B00000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies