MEDICARE: SELECT SPECIALTY - DOWNRIVER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282E00000X	Long Term Care Hospital

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	09321	OTHER	MI	BCBS MI

General Provider Information

NPI Number	:	1881694230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT SPECIALTY - DOWNRIVER LLC

Provider Business Mailing Address
First Line	:	4714 GETTYSBURG RD
Second Line	:	LEGAL DEPT.
City	:	MECHANICSBURG
State	:	PA
Zip	:	17055-4325
Country	:	US
Telephone Number	:	717-972-1100
Fax Number	:	717-975-9981

Provider Business Practice Location Address
First Line	:	2333 BIDDLE AVE
Second Line	:	8TH FLOOR
City	:	WYANDOTTE
State	:	MI
Zip	:	48192-4668
Country	:	US
Telephone Number	:	734-324-3571
Fax Number	:	734-246-8850

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. JOHN DUGGAN
Credential	:
Telephone Number	:	717-972-1100

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	09/10/2025

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