Rebuilder Medical Technologies of Nevada, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

REBUILDER MEDICAL TECHNOLOGIES OF NEVADA, INC.

Practice address

636 Treeline Dr
Suite B
Charles Town, WV 25414-4700

Phone

(877) 585-8230

Fax

(304) 725-4915

NPI assigned

Sep 18, 2008

Organization subpart

No

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

Authorized official

Name

Mr. David B. Phillips

Title

President/Ceo

Phone

(877) 585-8230

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327017600000",
    "number": "1245489822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 TREELINE DR",
            "address_2": "SUITE B",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254144700",
            "telephone_number": "877-585-8230",
            "fax_number": "304-725-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 TREELINE DR",
            "address_2": "SUITE B",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254144700",
            "telephone_number": "877-585-8230",
            "fax_number": "304-725-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBUILDER MEDICAL TECHNOLOGIES OF NEVADA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2012-01-20",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "877-585-8230",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "001612860",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Pretre
• Kirsten Daniell Pritt
• Professional Sportscare & Rehab of West Virginia, LLC
• Heather Rainey
• Jacqueline Raugh, LPC
• Rebuilder Medical Technologies, Inc.
• Rebuilder Medical, Inc.
• Jordan Redman
• Edward Renehan, ATC
• Anne Mary Rhoades, SLP

• Durable Medical Equipment & Medical Supplies in Charles Town, WV
• Providers in Charles Town, WV by specialty
• Durable Medical Equipment & Medical Supplies in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; 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.