Organization
SELECT SPECIALTY HOSPITAL - NORTHEAST OHIO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN DUGGAN (VICE PRESIDENT)
(717) 972-1139
Entity
Organization
Contact information
Practice address
1320 MERCY DR NW, 6TH FLOOR, CANTON, OH 44708-2614
(330) 344-1030
(330) 344-6035
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
1421
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000157636
BCBS OH
OH
01
—
123635400
BLACK LUNG
OH
05
—
2012968
—
OH
Enumeration date
07/26/2005
Last updated
09/10/2025
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