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General NPI Number Information
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NPI Number | 1306448899
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Entity Type | Organization
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Legal Business Name | SHANNON REHABILITATION HOSPITAL, LLC
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Dates
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Enumeration Date | 11/10/2020
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 6046 APPALOOSA TRAIL
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City | SAN ANGELO
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State | TX
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Zip | 76901
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Country | US
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Telephone | 999-999-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 9001 LIBERTY PKWY
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City | BIRMINGHAM
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State | AL
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Zip | 35242-7509
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Country | US
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Telephone | 59-677-1162
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Fax | 205-969-6650
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Authorized Official
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Title or Position | SR. VICE PRESIDENT OF THE MANAGER
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Name | CAREY BENNETT MCRAE
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Credential |
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Telephone | 205-970-3442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number |
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License Number State |
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