TOTAL REHAB SERVICES, PA

Provider Demographics

• NPI: 1952304164
• Name: TOTAL REHAB SERVICES, PA
• Entity Type: Organization
• Organization Name: TOTAL REHAB SERVICES, PA
• Authorized Official - Title/Position: PRESIDENT
• Authorized Official - Prefix: MRS
• Authorized Official - First Name: MARILYN
• Authorized Official - Middle Name: RICHMAN
• Authorized Official - Last Name: PICOW
• Authorized Official - Credentials: OTRL
• Authorized Official - Phone: 803-736-5540
• Mailing Address - Street 1: 9600 TWO NOTCH RD
• Mailing Address - Street 2: STE 24
• Mailing Address - City: COLUMBIA
• Mailing Address - State: SC
• Mailing Address - Zip Code: 29223-1613
• Mailing Address - Country: US
• Mailing Address - Phone: 803-736-5540
• Mailing Address - Fax: 803-699-0951
• Practice Address - Street 1: 9600 TWO NOTCH RD
• Practice Address - Street 2: STE 24
• Practice Address - City: COLUMBIA
• Practice Address - State: SC
• Practice Address - Zip Code: 29223-1613
• Practice Address - Country: US
• Practice Address - Phone: 803-736-5540
• Practice Address - Fax: 803-699-0951
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2005-05-23
• Last Update Date: 2012-08-23

Provider Licenses

State	License ID	Taxonomies
SC	0141905	224Z00000X, 225100000X, 2251E1200X, 2251G0304X, 2251N0400X, 2251S0007X, 2251X0800X, 225200000X, 225700000X, 225X00000X, 225XH1200X, 225XN1300X, 225XP0200X, 235Z00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	225100000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist		Group - Multi-Specialty
No	224Z00000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapy Assistant		Group - Multi-Specialty
No	2251E1200X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist	Ergonomics	Group - Multi-Specialty
No	2251G0304X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist	Geriatrics	Group - Multi-Specialty
No	2251N0400X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist	Neurology	Group - Multi-Specialty
No	2251S0007X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist	Sports	Group - Multi-Specialty
No	2251X0800X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist	Orthopedic	Group - Multi-Specialty
No	225200000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapy Assistant		Group - Multi-Specialty
No	225700000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Massage Therapist		Group - Multi-Specialty
No	225X00000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist		Group - Multi-Specialty
No	225XH1200X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist	Hand	Group - Multi-Specialty
No	225XN1300X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist	Neurorehabilitation	Group - Multi-Specialty
No	225XP0200X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist	Pediatrics	Group - Multi-Specialty
No	235Z00000X	Speech, Language and Hearing Service Providers	Speech-Language Pathologist		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
SC	GP0274	Medicaid
SC	1055662	Other	FIRST HEALTH NETWORK
SC	GP0274	Medicaid