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Organization
SELECT SPECIALTY HOSPITAL - FORT WAYNE INC
Active
Organization
SELECT SPECIALTY HOSPITAL - FORT WAYNE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL E. TARVIN (VICE PRESIDENT)
(717) 972-1100
Entity
Organization
Contact information
Practice address
700 BROADWAY, 7TH FL EAST, FORT WAYNE, IN 46802-1402
(260) 425-3811
(260) 425-3812
Mailing address
4714 GETTYSBURG RD, LEGAL DEPT., MECHANICSBURG, PA 17055-4325
(717) 972-1100
(717) 975-9981
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
009856
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000246982
BCBS IN
IN
Enumeration date
07/20/2005
Last updated
09/02/2010
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