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Organization
SELECT SPECIALTY HOSPITAL - BLOOMINGTON INC
Active
Organization
SELECT SPECIALTY HOSPITAL - BLOOMINGTON INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL E. TARVIN (VICE PRESIDENT)
(717) 972-1139
Entity
Organization
Contact information
Practice address
601 W 2ND ST, 4TH FLOOR, BLOOMINGTON, IN 47402-2317
(812) 353-2002
(812) 353-2001
Mailing address
4716 OLD GETTYSBURG RD, LEGAL DEPT., MECHANICSBURG, PA 17055-4325
(717) 972-1139
(717) 975-9981
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
003061
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000227863
BCBS IN
IN
Enumeration date
07/12/2005
Last updated
03/11/2008
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