Provider Demographics
NPI:1366689556
Name:REBIRTH VENTURES
Entity type:Organization
Organization Name:REBIRTH VENTURES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLADELE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEHINDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-675-7167
Mailing Address - Street 1:6108 DAWNVIEW CT
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75249-3816
Mailing Address - Country:US
Mailing Address - Phone:214-675-7167
Mailing Address - Fax:817-394-1256
Practice Address - Street 1:6108 DAWNVIEW CT
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75249-3816
Practice Address - Country:US
Practice Address - Phone:214-675-7167
Practice Address - Fax:817-394-1256
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VINTAGE CONSTRUCTION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies