MEDICARE: NOVACARE OUTPATIENT REHABILITATION 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	261QP2000X	Physical Therapy Clinic/Center		PA

General Provider Information

NPI Number	:	1770582660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVACARE OUTPATIENT REHABILITATION EAST INC

Provider Business Mailing Address
First Line	:	4714 GETTYSBURG RD
Second Line	:	LEGAL DEPARTMENT
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	:	5 S 3RD ST
Second Line	:
City	:	CLEARFIELD
State	:	PA
Zip	:	16830-2324
Country	:	US
Telephone Number	:	814-768-3550
Fax Number	:	817-768-7750

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. MICHAEL E. TARVIN
Credential	:
Telephone Number	:	717-972-1100

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	03/01/2018

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