Provider Demographics
NPI:1790714624
Name:REHAB MEDICAL, LLC
Entity Type:Organization
Organization Name:REHAB MEDICAL, LLC
Other - Org Name:REHAB MEDICAL, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-813-0205
Mailing Address - Street 1:3750 PRIORITY WAY SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-3831
Mailing Address - Country:US
Mailing Address - Phone:317-786-6871
Mailing Address - Fax:317-786-6870
Practice Address - Street 1:6011 E HANNA AVE STE J
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-7115
Practice Address - Country:US
Practice Address - Phone:317-786-6871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REHAB MEDICAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-02
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5623570001Medicare NSC