Organization Name: | SOUTHERN REHAB AND SPORTS MEDICINE, INC. |
NPI Number: | 1215167515 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSHUA D MCGINTY (VICE PRESIDENT, PHYSICAL THERAPIST) |
Mailing Address: | 1805 Vernon Rd Suite A Lagrange |
State: | GA US |
Postal Code: | 302403871 |
Phone Number: | 7068459383 |
Fax Number: | 7068459482 |
NPI Enumeration Date: | 07/21/2009 |
NPI Last Update Date: | 11/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |