Provider Demographics
NPI:1649220112
Name:SHARON REGIONAL HEALTH SYSTEM
Entity Type:Organization
Organization Name:SHARON REGIONAL HEALTH SYSTEM
Other - Org Name:SRHS REHAB UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHROBAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-983-3815
Mailing Address - Street 1:699 E STATE ST
Mailing Address - Street 2:SRHS (REHAB)
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-2057
Mailing Address - Country:US
Mailing Address - Phone:724-983-3817
Mailing Address - Fax:724-983-3941
Practice Address - Street 1:740 E STATE ST
Practice Address - Street 2:SRHS REHAB UNIT
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-3328
Practice Address - Country:US
Practice Address - Phone:724-983-3817
Practice Address - Fax:724-983-3941
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHARON REGIONAL HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-12
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA196601273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0967OtherBLUE CROSS
39T211Medicare ID - Type Unspecified