Provider Demographics
NPI:1598863086
Name:EDWIN SHAW REHAB LLC
Entity Type:Organization
Organization Name:EDWIN SHAW REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR-PATIENT FINANCIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOYT
Authorized Official - Suffix:
Authorized Official - Credentials:BS/MBA
Authorized Official - Phone:330-344-2032
Mailing Address - Street 1:330 BROADWAY ST E
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3312
Mailing Address - Country:US
Mailing Address - Phone:330-784-1271
Mailing Address - Fax:
Practice Address - Street 1:330 BROADWAY ST E
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3312
Practice Address - Country:US
Practice Address - Phone:330-784-1271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH100098OtherQUALCHOICE
OH000000360936OtherANTHEM BLUE CROSS
OH2600751Medicaid
OH000000360936OtherANTHEM BLUE CROSS
OH2600751Medicaid