Provider Demographics
NPI:1497135412
Name:SELBY GENERAL HOSPITAL
Entity Type:Organization
Organization Name:SELBY GENERAL HOSPITAL
Other - Org Name:INPATIENT REHAB
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-568-2000
Mailing Address - Street 1:1106 COLEGATE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-1323
Mailing Address - Country:US
Mailing Address - Phone:740-568-2000
Mailing Address - Fax:740-568-2094
Practice Address - Street 1:1106 COLEGATE DR
Practice Address - Street 2:INPATIENT REHAB
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1323
Practice Address - Country:US
Practice Address - Phone:740-374-1407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SELBY GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-04
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit