Provider Demographics
NPI:1619993797
Name:INPATIENT REHABILITATION GROUP INC
Entity type:Organization
Organization Name:INPATIENT REHABILITATION GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NINO
Authorized Official - Middle Name:
Authorized Official - Last Name:DIIULLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-433-9200
Mailing Address - Street 1:6525 WEST CAMPUS OVAL
Mailing Address - Street 2:STE 150
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054
Mailing Address - Country:US
Mailing Address - Phone:614-433-9200
Mailing Address - Fax:614-433-9201
Practice Address - Street 1:349 OLDE RIDENOUR RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-2528
Practice Address - Country:US
Practice Address - Phone:614-433-9200
Practice Address - Fax:614-433-9201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHIN9365831Medicare PIN