Provider Demographics
NPI:1548457708
Name:SELECT MEDICAL SYSTEMS, INC.
Entity type:Organization
Organization Name:SELECT MEDICAL SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MYRON
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-383-1607
Mailing Address - Street 1:1833 ALTON RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35210-4736
Mailing Address - Country:US
Mailing Address - Phone:205-383-1607
Mailing Address - Fax:205-383-1627
Practice Address - Street 1:1833 ALTON RD
Practice Address - Street 2:SUITE 105
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35210-4736
Practice Address - Country:US
Practice Address - Phone:205-383-1607
Practice Address - Fax:205-383-1627
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SELECT MEDICAL SYSTEMS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL07016137291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory