MEDICARE: REHABCLINICS (SPT), 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

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	:	1962888339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHABCLINICS (SPT), INC.

Provider Business Mailing Address
First Line	:	4714 GETTYSBURG RD
Second Line	:
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	:	2 COLGATE DR
Second Line	:	SUITE 102
City	:	FOREST HILL
State	:	MD
Zip	:	21050-2635
Country	:	US
Telephone Number	:	410-879-7769
Fax Number	:

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

Provider Enumeration Date	:	08/07/2015
Last Update Date	:	08/07/2015

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