Medical Rehab Supply, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0068028 Issued in TX

Legal business name

MEDICAL REHAB SUPPLY, INC

Practice address

3636 Camino del Rio N Ste 150
San Diego, CA 92108-1709

Phone

(844) 285-1135

Fax

(800) 693-5073

NPI assigned

Apr 10, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Letticia A Engleman

Title

Owner

Phone

(844) 285-1135

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522627200000",
    "number": "1023071099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 CAMINO DEL RIO N STE 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081709",
            "telephone_number": "844-285-1135",
            "fax_number": "800-693-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 CAMINO DEL RIO N STE 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081709",
            "telephone_number": "844-285-1135",
            "fax_number": "800-693-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL REHAB SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2018-04-02",
        "status": "A",
        "authorized_official_last_name": "ENGLEMAN",
        "authorized_official_first_name": "LETTICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "844-285-1135"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0068028",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0013103",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010367301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.