Provider Demographics
NPI:1629764865
Name:REHABTECH SUPPLY, LLC
Entity Type:Organization
Organization Name:REHABTECH SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DACY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-800-9445
Mailing Address - Street 1:655 W GRAND AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-1061
Mailing Address - Country:US
Mailing Address - Phone:847-219-8776
Mailing Address - Fax:
Practice Address - Street 1:8343 MELROSE DR BLDG E-1
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66214-1629
Practice Address - Country:US
Practice Address - Phone:888-800-9445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies