MEDICARE: SELECT SPECIALTY HOSPITAL - COLUMBUS EAST INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282E00000X	Long Term Care Hospital	1430	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000251611	OTHER	OH	BCBS OH

General Provider Information

NPI Number	:	1215936810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT SPECIALTY HOSPITAL - COLUMBUS EAST INC

Provider Business Mailing Address
First Line	:	4716 OLD GETTYSBURG RD
Second Line	:	LEGAL DEPT.
City	:	MECHANICSBURG
State	:	PA
Zip	:	17055-4325
Country	:	US
Telephone Number	:	717-972-1139
Fax Number	:	717-975-9981

Provider Business Practice Location Address
First Line	:	1492 E BROAD ST
Second Line	:	7TH FLOOR
City	:	COLUMBUS
State	:	OH
Zip	:	43205-1546
Country	:	US
Telephone Number	:	614-293-6797
Fax Number	:	614-293-6933

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. MICHAEL E. TARVIN
Credential	:
Telephone Number	:	717-972-1139

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	04/20/2008

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