MEDICARE: SYLACAUGA HEALTH & REHAB SERVICES, 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	314000000X	Skilled Nursing Facility	12680	AL

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

General Provider Information

NPI Number	:	1447201223
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYLACAUGA HEALTH & REHAB SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1123
Second Line	:
City	:	SYLACAUGA
State	:	AL
Zip	:	35150-1123
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1007 W FORT WILLIAMS ST
Second Line	:
City	:	SYLACAUGA
State	:	AL
Zip	:	35150-2301
Country	:	US
Telephone Number	:	256-245-7402
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	MR. DAVID WILBANKS
Credential	:
Telephone Number	:	256-245-7402

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	08/22/2020

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