Organization
REHABTECH SUPPLY, LLC
Active
Other names
Life Tech
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN DACY (PRESIDENT)
(888) 800-9445
Entity
Organization
Contact information
Practice address
655 W GRAND AVE, SUITE 100, ELMHURST, IL 60126-1060
(888) 800-9445
(888) 800-1991
Mailing address
655 W GRAND AVE, SUITE 100, ELMHURST, IL 60126-1060
(888) 800-9445
(888) 800-1991
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203001157
IL
332B00000X
Durable Medical Equipment & Medical Supplies
69000699A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902137409
—
WI
05
—
200994870 A
—
IN
05
—
620078942
—
MO
Enumeration date
01/22/2010
Last updated
03/18/2022
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