Provider Demographics
NPI:1710255146
Name:HEALTH FACILITIES REHAB SERVICES INC
Entity Type:Organization
Organization Name:HEALTH FACILITIES REHAB SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:B
Authorized Official - Last Name:BEDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-471-1276
Mailing Address - Street 1:1102 SIKES AVE
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-5021
Mailing Address - Country:US
Mailing Address - Phone:573-471-2544
Mailing Address - Fax:
Practice Address - Street 1:421 LINE ST
Practice Address - Street 2:SUITE B
Practice Address - City:NEW MADRID
Practice Address - State:MO
Practice Address - Zip Code:63869-1733
Practice Address - Country:US
Practice Address - Phone:573-748-5043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH FACILITIES REHAB SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-13
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO578094500Medicaid
MO578094500Medicaid