Provider Demographics
NPI:1578896395
Name:REHAB SPECIALISTS NC, LLC
Entity Type:Organization
Organization Name:REHAB SPECIALISTS NC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-669-7342
Mailing Address - Street 1:PO BOX 56548
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-9548
Mailing Address - Country:US
Mailing Address - Phone:888-669-7342
Mailing Address - Fax:888-705-4040
Practice Address - Street 1:1200 CHILMARK AVE
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-5335
Practice Address - Country:US
Practice Address - Phone:888-669-7342
Practice Address - Fax:888-705-4040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACFO02178335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier