1750436432 NPI number — FOSTORIA HOSPITAL ASSOCIATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750436432 NPI number — FOSTORIA HOSPITAL ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOSTORIA HOSPITAL ASSOCIATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750436432
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 VAN BUREN ST
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
FOSTORIA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44830
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-435-6560
Provider Business Mailing Address Fax Number:
419-435-6562

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 VAN BUREN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FOSTORIA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44830-1534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-435-6560
Provider Business Practice Location Address Fax Number:
419-435-6562
Provider Enumeration Date:
01/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
COEHRS
Authorized Official First Name:
BRYAN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PHARMACY
Authorized Official Telephone Number:
567-585-3041

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 021663150 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2080623 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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