Organization
REBUILDER MEDICAL TECHNOLOGIES OF NEVADA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID B. PHILLIPS (PRESIDENT/CEO)
(877) 585-8230
Entity
Organization
Contact information
Practice address
636 TREELINE DR, SUITE B, CHARLES TOWN, WV 25414-4700
(877) 585-8230
(304) 725-4915
Mailing address
636 TREELINE DR, SUITE B, CHARLES TOWN, WV 25414-4700
(877) 585-8230
(304) 725-4915
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001612860
BLUE CROSS BLUE SHIELD
WV
Enumeration date
09/18/2008
Last updated
01/20/2012
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