1316944184 NPI number — ALLIED SERVICES INSTITUTE OF REHABILITATION MEDICINE

Table of content: (NPI 1316944184)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316944184 NPI number — ALLIED SERVICES INSTITUTE OF REHABILITATION MEDICINE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLIED SERVICES INSTITUTE OF REHABILITATION MEDICINE
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:
ALLIED SERVICES REHABILITATION HOSPITAL
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:
1316944184
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 ABINGTON EXECUTIVE PARK
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLARKS SUMMIT
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18411-2258
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-348-1364
Provider Business Mailing Address Fax Number:
570-341-4646

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
475 MORGAN HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18508-2605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-348-1300
Provider Business Practice Location Address Fax Number:
570-341-4551
Provider Enumeration Date:
07/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
CONABOY
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
PREDIDENT
Authorized Official Telephone Number:
570-348-1458

Provider Taxonomy Codes

  • Taxonomy code: 283X00000X , with the licence number:  016901 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100000291 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001166334 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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