Provider Demographics
NPI:1255374799
Name:GOOD SHEPHERD REHABILITATION HOSPITAL
Entity type:Organization
Organization Name:GOOD SHEPHERD REHABILITATION HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-776-3130
Mailing Address - Street 1:850 S 5TH ST
Mailing Address - Street 2:GOOD SHEPHERD PLAZA
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3308
Mailing Address - Country:US
Mailing Address - Phone:610-776-8303
Mailing Address - Fax:610-778-9272
Practice Address - Street 1:3200 CENTER VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-9519
Practice Address - Country:US
Practice Address - Phone:610-776-3100
Practice Address - Fax:610-778-9272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA070801283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007608230009Medicaid
39-0335OtherBLUE CROSS
39-0335OtherBLUE CROSS