Provider Demographics
NPI:1952442063
Name:RIPPEE REHAB INC
Entity Type:Organization
Organization Name:RIPPEE REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIPPEE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:901-388-4444
Mailing Address - Street 1:5134 STAGE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3153
Mailing Address - Country:US
Mailing Address - Phone:901-388-4444
Mailing Address - Fax:901-388-9399
Practice Address - Street 1:5134 STAGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-3153
Practice Address - Country:US
Practice Address - Phone:901-412-4516
Practice Address - Fax:901-388-9399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCRT318261QR0401X
TNCRT3018305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No305R00000XManaged Care OrganizationsPreferred Provider Organization