Provider Demographics
NPI:1255386280
Name:PREMIER REHABILITATION CENTER INC
Entity type:Organization
Organization Name:PREMIER REHABILITATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEKONIS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:610-296-5300
Mailing Address - Street 1:PO BOX 666
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-0666
Mailing Address - Country:US
Mailing Address - Phone:610-296-5300
Mailing Address - Fax:
Practice Address - Street 1:254 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3087
Practice Address - Country:US
Practice Address - Phone:610-296-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1744705OtherHIGHMARK BLUE SHIELD
PA2411072000OtherINDEPENDENCE BLUE CROSS
PA0219600OtherORTHONET/CIGNA