Provider Demographics
NPI:1720380199
Name:SHCP, MEDINA, INC.
Entity Type:Organization
Organization Name:SHCP, MEDINA, INC.
Other - Org Name:MEDINA REHAB & NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-725-1550
Mailing Address - Street 1:550 MINER DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-1472
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 MINER DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1472
Practice Address - Country:US
Practice Address - Phone:330-725-1550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHCP, MEDINA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory