Provider Demographics
NPI:1629101068
Name:REHABILITATION DRUG SERVICES INC
Entity Type:Organization
Organization Name:REHABILITATION DRUG SERVICES INC
Other - Org Name:LIFE & HEALTH COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-242-2519
Mailing Address - Street 1:1814 CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-1229
Mailing Address - Country:US
Mailing Address - Phone:606-242-2519
Mailing Address - Fax:606-242-2520
Practice Address - Street 1:1814 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-1229
Practice Address - Country:US
Practice Address - Phone:606-242-2519
Practice Address - Fax:606-242-2520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7401722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY740172OtherSPECIAL HEALTH CLINIC