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Organization

PAM SQUARED AT TEXARKANA, LLC

Active
Other names
PAM Specialty Hospital of Texarkana South
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ANTHONY F. MISITANO (PRESIDENT)
(717) 731-9660
Entity
Organization

Contact information

Practice address
1000 PINE ST, 6TH FLOOR, TEXARKANA, TX 75501-5100
(903) 798-7600
Mailing address
1828 GOOD HOPE RD, SUITE 102, ENOLA, PA 17025-1233
(717) 731-9660
(717) 731-9665

Taxonomy

Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200645170 B
OK
05
208485105
AR
05
357622501
TX
05
357622502
TX
Enumeration date
09/15/2014
Last updated
10/20/2016
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