Provider Demographics
NPI:1588621437
Name:JOHN HEINZ INSTITUTE OF REHABILITATION MEDICINE
Entity Type:Organization
Organization Name:JOHN HEINZ INSTITUTE OF REHABILITATION MEDICINE
Other - Org Name:HEINZ TRANSITIONAL REHABILITATION UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:CONABOY
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:570-348-1458
Mailing Address - Street 1:150 MUNDY ST
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18702-6830
Mailing Address - Country:US
Mailing Address - Phone:570-826-3800
Mailing Address - Fax:570-826-9108
Practice Address - Street 1:150 MUNDY ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18702-6830
Practice Address - Country:US
Practice Address - Phone:570-826-3800
Practice Address - Fax:570-826-9108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA072223OtherFIRST PRIORITY HEALTH
PA114812OtherGEISINGER HEALTH PLAN
PA273759OtherHEALTH AMERICA
PA0527014OtherAETNA
PA00226OtherFREEDOM BLUE
PA396109OtherBLUE CROSS NEPA
PA396109Medicare Oscar/Certification
PA396109OtherBLUE CROSS NEPA