NPIMap

Organization Active NPI

Novacare Outpatient Rehabilitation East Inc

Doing business as NovaCare Rehabilitation

  • Durable Medical Equipment & Medical Supplies
  • Fridley, MN
National Provider Identifier
1063620672
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
NOVACARE OUTPATIENT REHABILITATION EAST INC
Doing business as
NovaCare Rehabilitation
Practice address
8290 University Avenue NW
Suite 300
Fridley, MN 55432
Phone
(763) 784-2340
Fax
(763) 786-1046
NPI assigned
May 18, 2007
Last updated
Mar 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Authorized official

Name
Michael Tarvin
Title
Vice President
Phone
(717) 975-4503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

8290 University Avenue NW
Suite 300
Fridley, MN 55432

Mailing address

4716 Gettysburg Rd
Legal Department
Mechanicsburg, PA 17055-4325
Phone (717) 975-4503

Other names 1

  • NovaCare Rehabilitation Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Novacare Outpatient Rehab50 organizations share this tax ID, including this one

Other organizations with this tax ID 49

Organizations that report the same tax identification number in the National Provider Directory.

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1063620672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 GETTYSBURG RD",
            "address_2": "LEGAL DEPARTMENT",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-975-4503",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8290 UNIVERSITY AVENUE NW",
            "address_2": "SUITE 300",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "55432",
            "telephone_number": "763-784-2340",
            "fax_number": "763-786-1046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVACARE OUTPATIENT REHABILITATION EAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-975-4503"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NovaCare Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fridley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.