Provider Demographics
NPI:1962001123
Name:TACTICAL REHABILITATION INC
Entity type:Organization
Organization Name:TACTICAL REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-262-9720
Mailing Address - Street 1:2040 WILMINGTON HWY STE A
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-3191
Mailing Address - Country:US
Mailing Address - Phone:423-262-9720
Mailing Address - Fax:
Practice Address - Street 1:1891 HWY 40 E STE 1108
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-6573
Practice Address - Country:US
Practice Address - Phone:904-420-7365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TACTICAL REHABILITATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-20
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier