Organization
SIMBA REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SALIM AHMED ABDUN PT (PT/CHIEF MANAGER)
(901) 292-4906
Entity
Organization
Contact information
Practice address
1149 TRAVERS LN, CORDOVA, TN 38018-8835
(901) 292-4906
(901) 386-7783
Mailing address
1149 TRAVERS LN, CORDOVA, TN 38018-8835
(901) 292-4906
(901) 386-7783
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
PT0000005160
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4051247
BLUECROSS BLUESHIELD
TN
Enumeration date
11/13/2007
Last updated
11/13/2007
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