Organization
FULLER REHABILITATION AND CONSULTING SERVICES INC.
Active
Parent organization
FULLER REHABILITATION AND CONSULTING SERVICES INC.
Other names
Fuller Rehabilitation
Organization subpart
Yes
Provider details
NPI number
Legal business name
FULLER REHABILITATION AND CONSULTING SERVICES INC.
Authorized official
MR. CARTER D. FULLER (PRESIDENT, CEO)
(706) 965-0352
Entity
Organization
Contact information
Practice address
90 ALEXANDRIA PIKE, SUITE 10, FORT THOMAS, KY 41075-4102
(859) 442-5191
(859) 442-5473
Mailing address
PO BOX 615, RINGGOLD, GA 30736-0615
(706) 965-6131
(706) 413-1352
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0952950009
MEDICARE ID-TYPE UNSPECIFIED
KY
05
—
200482310A
—
IN
05
—
2552910
—
OH
05
—
90001918
—
KY
Enumeration date
09/20/2006
Last updated
10/23/2009
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