Provider Demographics
NPI:1699820258
Name:PARAMOUNT REHABILITATION SERVICES, PC
Entity Type:Organization
Organization Name:PARAMOUNT REHABILITATION SERVICES, PC
Other - Org Name:PARAMOUNT REHABILITATION SERVICES, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MANJUSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALEWAR
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:989-891-9800
Mailing Address - Street 1:2535 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708
Mailing Address - Country:US
Mailing Address - Phone:989-891-9800
Mailing Address - Fax:989-891-0800
Practice Address - Street 1:2535 22ND ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708
Practice Address - Country:US
Practice Address - Phone:989-891-9800
Practice Address - Fax:989-891-0800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501005570225100000X
MI5501006073225100000X
MI5501003922225100000X
225100000X, 332B00000X
MI5201004313225X00000X
MI1051100450225XH1200X
MI01092746235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI30738OtherBLUE CARE NETWORK
MI1017353OtherMCLAREN HEALTH PLAN
MI30738OtherBLUE CROSS BLUE SHIELD
MI404679870Medicaid
MI0987906OtherHEALTH PLUS
MI30738OtherBLUE CROSS BLUE SHIELD
MI7458370001Medicare PIN
MI23-6819Medicare PIN