Healthcare Provider Details

I. General information

NPI: 1912923988
Provider Name (Legal Business Name): POST ACUTE MEDICAL AT LULING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEMORIAL DR
LULING TX
78648-3213
US

IV. Provider business mailing address

1828 GOOD HOPE RD SUITE 102
ENOLA PA
17025-1233
US

V. Phone/Fax

Practice location:
  • Phone: 830-875-8400
  • Fax: 830-875-2080
Mailing address:
  • Phone: 717-731-9660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number000184
License Number StateTX

VIII. Authorized Official

Name: MS. ANTHONY F MISITANO
Title or Position: PRESIDENT
Credential:
Phone: 717-731-9660