1952122236 NPI number — H.B. MAGRUDER MEMORIAL HOSPITAL

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 1952122236 NPI number — H.B. MAGRUDER MEMORIAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
H.B. MAGRUDER MEMORIAL HOSPITAL
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:
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:
1952122236
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
615 FULTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORT CLINTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43452-2001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-734-3131
Provider Business Mailing Address Fax Number:
419-960-8027

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3994 E HARBOR RD STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORT CLINTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43452-2645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-734-3131
Provider Business Practice Location Address Fax Number:
419-960-8027
Provider Enumeration Date:
10/21/2024

Additional Information

Authorized Official

Authorized Official Last Name:
NEUMANN
Authorized Official First Name:
EDMUND
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
DIR. CONSOLIDATED BUSINESS OFFICE
Authorized Official Telephone Number:
419-301-4336

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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