Provider Demographics
NPI:1831636869
Name:MEDREHAB, LLC
Entity Type:Organization
Organization Name:MEDREHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:STANGO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, OTD, MOT, ATP
Authorized Official - Phone:512-792-9501
Mailing Address - Street 1:2619 JONES RD STE C
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-2682
Mailing Address - Country:US
Mailing Address - Phone:512-792-9501
Mailing Address - Fax:512-792-9534
Practice Address - Street 1:2619 JONES RD STE C
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-2682
Practice Address - Country:US
Practice Address - Phone:512-792-9501
Practice Address - Fax:512-792-9534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-29
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment