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NPI Code Detail

MEDICARE: REGENCY HOSPITAL OF JACKSON, LLC

MEDICARE: REGENCY HOSPITAL OF JACKSON, LLC
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 Hospital

General Provider Information

NPI Number : 1851357925
Entity Type Code : Organization
Provider Name (Legal Business Name) : REGENCY HOSPITAL OF JACKSON, LLC
Provider Business Mailing Address
First Line : 4714 GETTYSBURG RD
Second Line : LEGAL DPT
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 : 969 LAKELAND DR
Second Line : 6TH FLOOR
City : JACKSON
State : MS
Zip : 39216-4606
Country : US
Telephone Number : 864-255-1401
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : MICHAEL TARVIN
Credential :
Telephone Number : 717-972-1100
Provider Enumeration Date : 04/26/2006
Last Update Date : 03/24/2011

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Directions to “REGENCY HOSPITAL OF JACKSON, LLC ” Practice Location

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