Provider Demographics
NPI:1750471181
Name:ALTERNACARE PHYSICAL MEDICINE AND REHABILITATION
Entity Type:Organization
Organization Name:ALTERNACARE PHYSICAL MEDICINE AND REHABILITATION
Other - Org Name:ALTERNACARE HEALTH AND REHAB, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:DEBEASE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-304-1500
Mailing Address - Street 1:3500 HIGHWAY 34 E
Mailing Address - Street 2:SUITE #15
Mailing Address - City:SHARPSBURG
Mailing Address - State:GA
Mailing Address - Zip Code:30277-3555
Mailing Address - Country:US
Mailing Address - Phone:770-304-1500
Mailing Address - Fax:770-304-8148
Practice Address - Street 1:3500 HIGHWAY 34 E
Practice Address - Street 2:SUITE #15
Practice Address - City:SHARPSBURG
Practice Address - State:GA
Practice Address - Zip Code:30277-3555
Practice Address - Country:US
Practice Address - Phone:770-304-1500
Practice Address - Fax:770-304-8148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007800111N00000X
GACHI005791111N00000X
GA057610207R00000X
GA0013122255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty