Wilkes Barre Hospital Company LLC
Organization Active NPI Rehabilitation Hospital Unit · Wilkes Barre, PA
NPI 1104126317 · NPPES record last updated Apr 26, 2021
Key facts
- NPI
- 1104126317
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rehabilitation Hospital Unit 273Y00000X
- Legal business name
- WILKES BARRE HOSPITAL COMPANY LLC
- Practice address
- 575 N River St
Wilkes Barre, PA 18702-2634 - Phone
- (570) 829-8111
- Fax
- (570) 552-3030
- NPI assigned
- Oct 22, 2010
- Organization subpart
- Yes
- Parent organization (as reported)
- WILKES BARRE HOSPITAL COMPANY LLC
Authorized official
- Name
- Paula Lalor
- Title
- Director/Delegated Official
- Phone
- (629) 215-3953
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 4
Member organizations 2
Related certifications (CCN) 2
Facilities with the same owner 120
Affiliated clinicians 4
-
John A. Kline, M.D.
-
Vinit Pande, M.D.
-
William R. Prebola, M.D.
Medicare Care Compare: Inpatient rehabilitation facility
- Listed as
- Center for Advanced Rehab
- Ownership
- For profit
- Certified
- Jul 1, 2011
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Hospital certification: CCN 39T137
- Legal name
- WILKES BARRE HOSPITAL COMPANY LLC
- Doing business as
- WILKES BARRE GENERAL HOSPITAL
- Organization structure
- LLC · Proprietary
- Incorporated
- Oct 30, 2008 in DE
- Enrollment address
- 575 N River St
Wilkes Barre General Hospital
Wilkes Barre, PA 18764-0999 - Hospital subgroups
- Rehabilitation unit
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Kevin J Hammons |
Corporate Officer |
Mar 1, 2022 | |
| Corporate Director |
Mar 1, 2022 | ||
| Nathaniel K Summar |
Corporate Director |
Jul 15, 2017 | |
| Justin D Pitt |
Corporate Officer |
Mar 1, 2022 | |
| Corporate Director |
Mar 1, 2022 | ||
| Simon Ratliff |
W-2 Managing Employee |
Sep 1, 2022 | |
| William Bradley Cash |
Corporate Officer |
Mar 1, 2022 | |
| Hma-Tri Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jun 30, 2023 | 100% |
| Community Health Systems Inc |
5% Or Greater Indirect Ownership Interest | May 1, 2009 | 100% |
| Jason Kevin Johnson |
Corporate Officer |
Jan 6, 2020 | |
| Roman Gabriel Ottinger |
Corporate Officer |
Jan 6, 2020 | |
| Triad Healthcare, LLC |
5% Or Greater Indirect Ownership Interest | Jun 30, 2023 | 100% |
| Wilkes-Barre Holdings LLC |
5% Or Greater Direct Ownership Interest | May 1, 2009 | 100% |
| Paula M Lalor |
Corporate Director |
Apr 1, 2017 | |
| Tennyson Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jun 30, 2023 | 100% |
| Edna S Buffington-Price |
Corporate Director |
Mar 1, 2022 | |
| Scranton Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jun 30, 2023 | 100% |
| Christopher G Cobb |
Corporate Officer |
Mar 1, 2022 | |
| CHS Community Health Systems Inc |
5% Or Greater Indirect Ownership Interest | May 1, 2009 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110217000749 | PA | Part a Provider - Hospital | 5890845754 | Practice locations: Wilkes Barre, PA |
National Provider Directory
- Tax ID family
- Wilkes Barre Hospital Company LLC
- Part of
- Wilkes Barre Hospital Company LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Hospital Unit | 273Y00000X | Yes |
Addresses
Primary practice location
575 N River St
Wilkes Barre, PA 18702-2634
Mailing address
575 N River St
Wilkes Barre, PA 18764
Phone (570) 829-8111
Other names
- Wilkes Barre General Hospital
Other providers in Wilkes Barre, PA
- Wilkes Barre Behavioral Hospital Company LLC
- Wilkes Barre Behavioral Hospital Company LLC
- Wilkes Barre Behavioral Hospital Company LLC
- Wilkes Barre Chiropractic and Rehabilitition Inc
- Wilkes Barre Hospital Company LLC
- Wilkes Barre Hospital Company LLC
- Wilkes Barre Hospital Company LLC
- Wilkes Barre Imaging, LLC
- Wilkes Barre Scranton Chiropractic and Rehabilitation
- Wilkes Barre Skilled Nursing Services LLC
All providers in Wilkes Barre, PA · Rehabilitation Hospital Unit in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.