Provider Demographics
NPI:1578562625
Name:SOUTHERN INDIANA REHABILITATION HOSPITAL
Entity Type:Organization
Organization Name:SOUTHERN INDIANA REHABILITATION HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:NAPIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-941-6106
Mailing Address - Street 1:PO BOX 2587
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-2587
Mailing Address - Country:US
Mailing Address - Phone:502-587-4099
Mailing Address - Fax:502-587-4944
Practice Address - Street 1:3104 BLACKISTON BLVD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-9579
Practice Address - Country:US
Practice Address - Phone:812-941-8300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN050062051283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1058292OtherPASSPORT
KY2433921000OtherPASSPORT ADVANTAGE
IN030011100OtherBLACK LUNG
IN1018454OtherCHAMPUS
IN200715810AOtherIN MEDICAID FOR SIRH FIRST STEPS GROUP
IN5000072OtherUNITED HEALTHCARE
IN000000054356OtherANTHEM
IN129343300OtherUS DEPARTMENT OF LABOR
IN200350290AOtherIN MEDICAID FOR SIRH GROUP
IN200715810OtherIN FIRST STEPS
KY01341718Medicaid
IN100368680AMedicaid
KY01341718Medicaid
IN100368680AMedicaid
IN1018454OtherCHAMPUS