Provider Demographics
NPI:1831162544
Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF ERIE, LLC
Entity type:Organization
Organization Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF ERIE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
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 1:143 E 2ND ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1501
Practice Address - Country:US
Practice Address - Phone:814-878-1200
Practice Address - Fax:814-878-1399
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENCOMPASS HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-12
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA392001283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH00771259Medicaid
0126OtherBLUE CROSS
25126OtherHEALTH AMERICA
NY00937288Medicaid
PA0014557490003Medicaid
167726400OtherDEPT OF LABOR
1027658OtherGATEWAY
74442,0OtherTHREE RIVERS
393046OtherAETNA
PA0014557490003Medicaid