Provider Demographics
NPI:1629160452
Name:SALEM REHAB INC
Entity Type:Organization
Organization Name:SALEM REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:MANOR
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:877-343-9022
Mailing Address - Street 1:3115 WRIGHTSVILLE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4188
Mailing Address - Country:US
Mailing Address - Phone:877-343-9022
Mailing Address - Fax:877-343-9023
Practice Address - Street 1:3115 WRIGHTSVILLE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4188
Practice Address - Country:US
Practice Address - Phone:877-343-9022
Practice Address - Fax:877-343-9023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704376Medicaid