Provider Demographics
NPI:1841850443
Name:IR REHAB PC
Entity type:Organization
Organization Name:IR REHAB PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:RUESEWALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-699-3933
Mailing Address - Street 1:PO BOX 10340
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76547-0340
Mailing Address - Country:US
Mailing Address - Phone:254-699-3933
Mailing Address - Fax:254-526-8604
Practice Address - Street 1:2419 PALERMO PKWY BLDG A
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3790
Practice Address - Country:US
Practice Address - Phone:254-699-3933
Practice Address - Fax:254-526-8604
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IR REHAB PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-17
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation