Provider Demographics
NPI:1811961758
Name:GEISINGER ENCOMPASS HEALTH LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:GEISINGER ENCOMPASS HEALTH LIMITED LIABILITY COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCCALLUM
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:205-970-5669
Mailing Address - Street 1:9001 LIBERTY PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7509
Mailing Address - Country:US
Mailing Address - Phone:205-967-7116
Mailing Address - Fax:205-969-6650
Practice Address - Street 1:2 REHAB LN
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-8498
Practice Address - Country:US
Practice Address - Phone:570-271-6110
Practice Address - Fax:570-271-6796
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENCOMPASS HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-15
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA07180100283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01744062Medicaid
1539OtherBLUE CROSS
39T347OtherBLUE CROSS
81005OtherHEALTH ASSURANCE
38541OtherGEISNGER HEALTH
2128683OtherAETNA
93470OtherTHREE RIVERS
1505706OtherGATEWAY
390347OtherBLUE CROSS
PA01744062Medicaid