SELECT SPECIALTY HOSPITAL - PONTIAC INC NPI 1720088370

NPI Information

NPI: 1720088370
Provider Name: SELECT SPECIALTY HOSPITAL - PONTIAC INC
Classification: Long Term Care Hospital - 282E00000X
Entity Type: Organization

CLIA Number: 23D0985854

Address:
44405 WOODWARD AVE
7TH AND 8TH FLS
PONTIAC, MI
ZIP 48341
Phone: (248) 452-5206
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SELECT SPECIALTY HOSPITAL - PONTIAC INC is a long term care hospital in Pontiac, MI. The provider is long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions. SELECT SPECIALTY HOSPITAL - PONTIAC INC NPI is 1720088370. The provider is registered as an organization entity type.

The provider's business location address is:

44405 WOODWARD AVE
7TH AND 8TH FLS
PONTIAC, MI
ZIP 48341-023
Phone: (248) 452-5206
Fax: (248) 452-5208

The provider's authorized official is Michael E. Tarvin .
The authorized official title is Vice President and has the following contact phone number (717) 972-1100.

The CLIA number assigned to this NPI record is 23D0985854 - hospital with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/26/2005 and was last updated on 10/24/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	282E00000X	Long Term Care Hospital		630172	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	09322	OTHER	MICHIGAN	BCBS MI
2	232030	MEDICARE OSCAR/CERTIFICATION	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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