Provider Demographics
NPI:1609868595
Name:ALTOONA HEALTH & REHAB, INC.
Entity Type:Organization
Organization Name:ALTOONA HEALTH & REHAB, INC.
Other - Org Name:ALTOONA HEALTH & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGELOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-589-6394
Mailing Address - Street 1:P.O. BOX 68
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:AL
Mailing Address - Zip Code:35952
Mailing Address - Country:US
Mailing Address - Phone:205-589-6394
Mailing Address - Fax:205-589-2112
Practice Address - Street 1:6532 WALNUT GROVE RD
Practice Address - Street 2:6532 WALNUT GROVE RD
Practice Address - City:ALTOONA
Practice Address - State:AL
Practice Address - Zip Code:35952-8405
Practice Address - Country:US
Practice Address - Phone:205-589-6394
Practice Address - Fax:205-589-2112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10522314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4757390SMedicaidMEDICAID PROVIDER NUMBER
AL010483OtherBLUE CROSS BLUE SHEILD AL
AL4757390SMedicaidMEDICAID PROVIDER NUMBER
AL4757390SMedicaidMEDICAID PROVIDER NUMBER
AL5410050001Medicare NSC