Provider Demographics
NPI:1134307598
Name:NOVACARE
Entity Type:Organization
Organization Name:NOVACARE
Other - Org Name:NOVACARE
Other - Org Type:Other Name
Authorized Official - Title/Position:LEAD P.S.S.
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-768-5558
Mailing Address - Street 1:200 HOSPITAL DR
Mailing Address - Street 2:SUITE 506
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5884
Mailing Address - Country:US
Mailing Address - Phone:410-768-5558
Mailing Address - Fax:410-761-2797
Practice Address - Street 1:200 HOSPITAL DR
Practice Address - Street 2:SUITE 506
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5884
Practice Address - Country:US
Practice Address - Phone:410-768-5558
Practice Address - Fax:410-761-2797
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SELECT MEDICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty