Outpatient Rehabilitation Center of Fulton Inc

Organization Active NPI Rehabilitation Clinic/Center · Fulton, MS

NPI 1669538823 · NPPES record last updated Sep 27, 2018

Key facts

NPI
1669538823
Entity type
Organization (NPI type 2)
Primary specialty
Rehabilitation Clinic/Center 261QR0400X
Legal business name
OUTPATIENT REHABILITATION CENTER OF FULTON INC
Practice address
406 Interchange Drive
Fulton, MS 38843-8900
Phone
(662) 862-3070
Fax
(662) 862-4970
NPI assigned
Dec 29, 2006
Organization subpart
No

Authorized official

Name
Angie B Izard
Title
Office Manager
Phone
(662) 862-3070

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140131001518 MS Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2860567948 Receives reassigned benefits from 5 practitioners
Practice locations: Fulton, MS

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Yes

Addresses

Primary practice location

406 Interchange Drive
Fulton, MS 38843-8900

Mailing address

PO Box 188
Fulton, MS 38843-0188
Phone (662) 862-3070

Other providers in Fulton, MS

All providers in Fulton, MS · Rehabilitation Clinic/Center in Mississippi

Sources for this page

Verify at the official NPI Registry.