Provider Demographics
NPI:1205130200
Name:CUMBERLAND OUTPATIENT REHAB, LLC
Entity type:Organization
Organization Name:CUMBERLAND OUTPATIENT REHAB, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHWINI
Authorized Official - Middle Name:R
Authorized Official - Last Name:ANAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-862-0605
Mailing Address - Street 1:PO BOX 103
Mailing Address - Street 2:
Mailing Address - City:GARRARD
Mailing Address - State:KY
Mailing Address - Zip Code:40941-0103
Mailing Address - Country:US
Mailing Address - Phone:606-596-0884
Mailing Address - Fax:606-596-0047
Practice Address - Street 1:2983 SOUTH HWY 421
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-6212
Practice Address - Country:US
Practice Address - Phone:606-596-0884
Practice Address - Fax:606-596-0047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy