Provider Demographics
NPI:1811683923
Name:MEDSTAR HEALTH PHYSICAL THERAPY AT HOME, LLC.
Entity type:Organization
Organization Name:MEDSTAR HEALTH PHYSICAL THERAPY AT HOME, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-540-6140
Mailing Address - Street 1:102 IRVING ST NW RM G018
Mailing Address - Street 2:ATTN: JILL ANDERSON
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2921
Mailing Address - Country:US
Mailing Address - Phone:301-540-6140
Mailing Address - Fax:301-540-5190
Practice Address - Street 1:102 IRVING ST NW RM 1253
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2921
Practice Address - Country:US
Practice Address - Phone:301-540-6140
Practice Address - Fax:301-540-5190
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDSTAR NATIONAL REHABILITATION HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-12
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Single Specialty