Provider Demographics
NPI:1861825796
Name:REHAB ASSOCIATES, LLC
Entity Type:Organization
Organization Name:REHAB ASSOCIATES, LLC
Other - Org Name:CHAMPION SPORTS MEDICINE & REHABILITATION CNTR - SHELBY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT AND SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:TARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-972-1100
Mailing Address - Street 1:4714 GETTYSBURG RD
Mailing Address - Street 2:LEGAL DEPARTMENT
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4325
Mailing Address - Country:US
Mailing Address - Phone:717-972-1100
Mailing Address - Fax:
Practice Address - Street 1:3143 PELHAM PKWY
Practice Address - Street 2:SUITE 400
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-6300
Practice Address - Country:US
Practice Address - Phone:205-664-3197
Practice Address - Fax:206-621-5686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-14
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL016590Medicare Oscar/Certification