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NPI Code Detail

MEDICARE: SELECT SPECIALTY HOSPITAL - SOUTH DALLAS INC

MEDICARE: SELECT SPECIALTY HOSPITAL - SOUTH DALLAS 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
1282E00000XLong Term Care Hospital007859TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HH1028OTHERTXBCBS TX

General Provider Information

NPI Number : 1518967074
Entity Type Code : Organization
Provider Name (Legal Business Name) : SELECT SPECIALTY HOSPITAL - SOUTH DALLAS INC
Provider Business Mailing Address
First Line : 4714 GETTYSBURG RD
Second Line : LEGAL DEPT.
City : MECHANICSBURG
State : PA
Zip : 17055-4325
Country : US
Telephone Number : 717-972-1100
Fax Number : 717-975-9981
Provider Business Practice Location Address
First Line : 3500 W WHEATLAND RD
Second Line : 4TH FLOOR
City : DALLAS
State : TX
Zip : 75237-3460
Country : US
Telephone Number : 972-780-6514
Fax Number : 972-298-4860
Authorized Official
Title or Position : VICE PRESIDENT
Name : MR. MICHAEL E. TARVIN
Credential :
Telephone Number : 717-972-1100
Provider Enumeration Date : 07/27/2005
Last Update Date : 06/14/2012

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Directions to “SELECT SPECIALTY HOSPITAL - SOUTH DALLAS INC ” Practice Location

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