Organization
SELECT SPECIALTY HOSPITAL - INDIANAPOLIS 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
898 E MAIN ST, GREENWOOD, IN 46143-1407
(317) 925-8066
(317) 925-8861
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
006578
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097637
BCBS IN
IN
Enumeration date
07/21/2005
Last updated
03/11/2008
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