1043283757 NPI number — ENCOMPASS HEALTH REHABILITATION HOSPITAL OF CHARLESTON, LLC

Table of content: (NPI 1043283757)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043283757 NPI number — ENCOMPASS HEALTH REHABILITATION HOSPITAL OF CHARLESTON, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ENCOMPASS HEALTH REHABILITATION HOSPITAL OF CHARLESTON, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ENCOMPASS HEALTH REHABILITATION HOSPITAL OF CHARLESTON
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043283757
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9001 LIBERTY PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35242-7509
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-967-7116
Provider Business Mailing Address Fax Number:
205-969-6650

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9181 MEDCOM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-820-7777
Provider Business Practice Location Address Fax Number:
843-553-4025
Provider Enumeration Date:
02/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WISNER
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
205-970-5702

Provider Taxonomy Codes

  • Taxonomy code: 283X00000X , with the licence number:  HTL-648 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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