Provider Demographics
NPI:1639159395
Name:THERA CARE INC
Entity Type:Organization
Organization Name:THERA CARE INC
Other - Org Name:THERA CARE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REIMBURSEMENT MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:RENNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-965-0816
Mailing Address - Street 1:153 W MAIN ST
Mailing Address - Street 2:STE 101
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054
Mailing Address - Country:US
Mailing Address - Phone:614-855-0700
Mailing Address - Fax:614-855-5750
Practice Address - Street 1:153 W MAIN ST
Practice Address - Street 2:STE 101
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054
Practice Address - Country:US
Practice Address - Phone:614-855-0700
Practice Address - Fax:614-855-5750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2133551Medicaid
OH2133551Medicaid
OH=========02OtherBWC