Healthcare Provider Details

I. General information

NPI: 1578563326
Provider Name (Legal Business Name): SELECT SPECIALTY HOSPITAL - LITTLE ROCK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 09/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 SAINT VINCENT CIR 6TH FL
LITTLE ROCK AR
72205-5423
US

IV. Provider business mailing address

4714 GETTYSBURG RD LEGAL DEPT.
MECHANICSBURG PA
17055-4325
US

V. Phone/Fax

Practice location:
  • Phone: 501-552-8321
  • Fax: 501-603-9041
Mailing address:
  • Phone: 717-972-1100
  • Fax: 717-975-9981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License NumberAR3790
License Number StateAR

VIII. Authorized Official

Name: MR. MICHAEL E. TARVIN
Title or Position: VICE PRESIDENT
Credential:
Phone: 717-972-1100