Organization
COOPERATIVE REHAB SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY REINSCHMIDT (VP/CHIEF FINANCIAL OFFICER)
(904) 858-7488
Entity
Organization
Contact information
Practice address
1111 GLYNCO PKWY, SUITE 110, BRUNSWICK, GA 31525-7921
(912) 264-5377
(912) 262-1889
Mailing address
3599 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4252
(904) 858-7606
(904) 858-7476
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00969493A
—
GA
Enumeration date
06/15/2006
Last updated
09/21/2007
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