Provider Demographics
NPI:1174626527
Name:JC REHAB CENTER, INC.
Entity type:Organization
Organization Name:JC REHAB CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:CP, CFO
Authorized Official - Phone:787-256-1550
Mailing Address - Street 1:BAHUINIA ST. Z-975
Mailing Address - Street 2:LOIZA VALLEY
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:787-256-1550
Mailing Address - Fax:787-256-1551
Practice Address - Street 1:LOIZA VALLEY
Practice Address - Street 2:BAHUINIA ST. Z-975
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-256-1550
Practice Address - Fax:787-256-1551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4603000001Medicare NSC