Provider Demographics
NPI:1528206604
Name:REHAB OUTFITTERS, LLC
Entity Type:Organization
Organization Name:REHAB OUTFITTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:STRADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-893-8008
Mailing Address - Street 1:1100 LUKE ST
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-4004
Mailing Address - Country:US
Mailing Address - Phone:972-893-8008
Mailing Address - Fax:972-893-8009
Practice Address - Street 1:1100 LUKE ST
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-4004
Practice Address - Country:US
Practice Address - Phone:972-893-8008
Practice Address - Fax:972-893-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment