Basic Information
| Provider Information | |||||||||
| NPI: | 1689609612 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HAND & REHABILITATION SPECIALISTS OF NORTH CAROLINA LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 257 W KINGS HWY | ||||||||
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| City: | EDEN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272885009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3366274263 | ||||||||
| FaxNumber: | 3366274255 | ||||||||
| Practice Location | |||||||||
| Address1: | 610 N FAYETTEVILLE ST STE 201 | ||||||||
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| City: | ASHEBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272034671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3366334263 | ||||||||
| FaxNumber: | 3366334267 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 10/15/2012 | ||||||||
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| AuthorizedOfficialLastName: | WALSH | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | WARD | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR MANAGING PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 3366274263 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HAND & REHABILITATION SPECIALISTS OF NORTH CAROLINA LLP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XH1200X | NC | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand | 2251H1200X | NC | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Hand | 225X00000X | NC | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225100000X | NC | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 2502674 | 01 | NC | MEDICARE PHYSICAL THERAPY | OTHER | 7211109 | 05 | NC | MEDICAID | 0245G | 01 | NC | BCBSNC | OTHER | CE1514 | 01 | NC | MEDICARE RAILROAD | OTHER |