Provider Demographics
NPI:1609553494
Name:MEDSTAR HEALTH PHYSICAL THERAPY AT HOME, LLC.
Entity Type:Organization
Organization Name:MEDSTAR HEALTH PHYSICAL THERAPY AT HOME, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-540-6140
Mailing Address - Street 1:102 IRVING STREET, NW
Mailing Address - Street 2:ATTN: MHPT PAYOR ENROLLMENT
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2921
Mailing Address - Country:US
Mailing Address - Phone:301-540-6140
Mailing Address - Fax:301-540-5190
Practice Address - Street 1:4040 FAIRFAX DR STE 120A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1613
Practice Address - Country:US
Practice Address - Phone:703-292-4060
Practice Address - Fax:703-292-4066
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL REHABILITATION HOSPITAL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-03
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty