Healthcare Provider Details

I. General information

NPI: 1215550496
Provider Name (Legal Business Name): MIDLANDS REGIONAL REHABILITATION HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2020
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PINNACLE PARKWAY
ELGIN SC
29045-8389
US

IV. Provider business mailing address

1024 N GALLOWAY AVE STE 102
MESQUITE TX
75149-2434
US

V. Phone/Fax

Practice location:
  • Phone: 803-438-8890
  • Fax: 803-438-8889
Mailing address:
  • Phone: 972-216-2299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: DENISE KANN
Title or Position: VICE PRESIDENT AND SECRETARY
Credential:
Phone: 972-216-2299