Provider Demographics
NPI:1952196214
Name:TACTICAL REHABILITATION INC
Entity type:Organization
Organization Name:TACTICAL REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-275-4862
Mailing Address - Street 1:2040 WILMINGTON HWY STE A
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-3191
Mailing Address - Country:US
Mailing Address - Phone:910-210-0790
Mailing Address - Fax:910-210-0791
Practice Address - Street 1:10420 MONTWOOD DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-2701
Practice Address - Country:US
Practice Address - Phone:910-210-0790
Practice Address - Fax:910-210-0791
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TACTICAL REHABILITATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies