Basic Information
| Provider Information | |||||||||
| NPI: | 1205035359 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SHARON REGIONAL HEALTH SYSTEM | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | SHARON REGIONAL HEALTH SYSTEM HOME HEALTH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 699 E STATE ST | ||||||||
| Address2: | |||||||||
| City: | SHARON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161462057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249833817 | ||||||||
| FaxNumber: | 7249833941 | ||||||||
| Practice Location | |||||||||
| Address1: | 7264 WARREN SHARON RD | ||||||||
| Address2: | |||||||||
| City: | BROOKFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444039665 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249835681 | ||||||||
| FaxNumber: | 7249833902 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2007 | ||||||||
| LastUpdateDate: | 02/03/2012 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | CHROBAK | ||||||||
| AuthorizedOfficialFirstName: | JEFF | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT FOR FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 7249833815 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SHARON REGIONAL HEALTH SYSTEM | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | OH | N | Agencies | Case Management | 251F00000X | OH | N | Agencies | Home Infusion | 251J00000X | OH | N | Agencies | Nursing Care | 251V00000X | OH | N | Agencies | Voluntary or Charitable | 251E00000X | OH | Y | Agencies | Home Health |
No ID Information.