Rebuilder Medical, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

200295036001 Issued in WV

Legal business name

REBUILDER MEDICAL, INC.

Practice address

636 Treeline Dr
Charles Town, WV 25414-4700

Phone

(304) 725-2202

Fax

(304) 725-4915

NPI assigned

Aug 11, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Michael J Evans

Title

Billing Manager

Phone

(877) 436-3894

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261958400000",
    "number": "1679729610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 TREELINE DR",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254144700",
            "telephone_number": "304-725-2202",
            "fax_number": "304-725-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 TREELINE DR",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254144700",
            "telephone_number": "304-725-2202",
            "fax_number": "304-725-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBUILDER MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-11",
        "last_updated": "2009-12-28",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "877-436-3894",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WV",
            "license": "200295036001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "001612860",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Professional Sportscare & Rehab of West Virginia, LLC
• Heather Rainey
• Jacqueline Raugh, LPC
• Rebuilder Medical Technologies of Nevada, Inc.
• Rebuilder Medical Technologies, Inc.
• Jordan Redman
• Edward Renehan, ATC
• Anne Mary Rhoades, SLP
• Makenzie Faith Rhodes, PTA
• Richard Diaz, DDS Inc.

• 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 Dec 28, 2009; 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.