Provider Demographics
NPI:1861710238
Name:CARRUS REHABILITATION HOSPITAL
Entity type:Organization
Organization Name:CARRUS REHABILITATION HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANBARASU
Authorized Official - Middle Name:
Authorized Official - Last Name:NACHIMUTHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-489-7414
Mailing Address - Street 1:1810 W US HIGHWAY 82
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7069
Mailing Address - Country:US
Mailing Address - Phone:903-870-2600
Mailing Address - Fax:903-870-2601
Practice Address - Street 1:1810 W US HIGHWAY 82
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7069
Practice Address - Country:US
Practice Address - Phone:903-870-2600
Practice Address - Fax:903-870-2601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-11
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100059283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100059OtherPRIMARY TAXONOMY
TX673041Medicare UPIN
TX100059OtherPRIMARY TAXONOMY