Basic Information
| Provider Information | |||||||||
| NPI: | 1437292737 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAINT VINCENT REHAB SOLUTIONS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 153 E 13TH ST STE 1300 | ||||||||
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| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165031035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148605000 | ||||||||
| FaxNumber: | 8148605050 | ||||||||
| Practice Location | |||||||||
| Address1: | 1910 SASSAFRAS ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165022716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144527879 | ||||||||
| FaxNumber: | 8144552628 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2007 | ||||||||
| LastUpdateDate: | 11/09/2020 | ||||||||
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| AuthorizedOfficialLastName: | HATT | ||||||||
| AuthorizedOfficialFirstName: | TAMARA | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | SR. PROVIDER ENROLLMENT SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 8144525772 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SAINT VINCENT REHAB SOLUTIONS LLC | ||||||||
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| NPICertificationDate: | 11/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QX0100X | Y | Ambulatory Health Care Facilities | Clinic/Center | Occupational Medicine |
No ID Information.