Provider Demographics
NPI:1598803009
Name:HAMTRAMCK PT & REHAB INC.
Entity Type:Organization
Organization Name:HAMTRAMCK PT & REHAB INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:ARSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-366-8500
Mailing Address - Street 1:3530 CARPENTER ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-2766
Mailing Address - Country:US
Mailing Address - Phone:313-366-8500
Mailing Address - Fax:
Practice Address - Street 1:3530 CARPENTER ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-2766
Practice Address - Country:US
Practice Address - Phone:313-366-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4956854Medicaid