Provider Demographics
NPI:1811218423
Name:EFFINGHAM REHAB SERVICES, INC.
Entity Type:Organization
Organization Name:EFFINGHAM REHAB SERVICES, INC.
Other - Org Name:SPINE & SPORT CHARLESTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VPA
Authorized Official - Prefix:
Authorized Official - First Name:SEBRENA
Authorized Official - Middle Name:CAROLIN
Authorized Official - Last Name:HOLMES GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-826-1509
Mailing Address - Street 1:135 GOSHEN ROAD EXT
Mailing Address - Street 2:STE 206
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-5567
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4600 GOER DR
Practice Address - Street 2:STE 206
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-6500
Practice Address - Country:US
Practice Address - Phone:877-826-1509
Practice Address - Fax:912-826-9767
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EFFINGHAM REHAB SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy