Healthcare Provider Details

I. General information

NPI: 1962573956
Provider Name (Legal Business Name): POST ACUTE MEDICAL AT LULING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEMORIAL DR
LULING TX
78648-3213
US

IV. Provider business mailing address

4660 TRINDLE RD SUITE 200
CAMP HILL PA
17011-5610
US

V. Phone/Fax

Practice location:
  • Phone: 830-875-8400
  • Fax: 830-875-6899
Mailing address:
  • Phone: 717-730-8710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number000184
License Number StateTX

VIII. Authorized Official

Name: MR. ANTHONY F MISITANO
Title or Position: CEO
Credential:
Phone: 717-730-8710