Basic Information
| Provider Information | |||||||||
| NPI: | 1598862971 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BLANCHARD VALLEY REGIONAL HEALTH CENTER | ||||||||
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| OtherOrganizationName: | CREIGHTON DIALYSIS CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 SOUTH MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458401214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194235262 | ||||||||
| FaxNumber: | 4194235550 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 E MAIN CROSS ST | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458406317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194235184 | ||||||||
| FaxNumber: | 4194235519 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 10/29/2007 | ||||||||
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| AuthorizedOfficialLastName: | CYTLAK | ||||||||
| AuthorizedOfficialFirstName: | DAVE | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 4194235497 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QE0700X | Y | Ambulatory Health Care Facilities | Clinic/Center | End-Stage Renal Disease (ESRD) Treatment |
No ID Information.