Basic Information
| Provider Information | |||||||||
| NPI: | 1598948895 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SUMMA BARBERTON CITIZENS HOSPITAL | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | BARBERTON CITIZENS HOSPITAL SNF | ||||||||
| OtherOrganizationType: | 5 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 155 5TH ST NE | ||||||||
| Address2: | |||||||||
| City: | BARBERTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442033332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306153026 | ||||||||
| FaxNumber: | 3306153033 | ||||||||
| Practice Location | |||||||||
| Address1: | 155 5TH ST NE | ||||||||
| Address2: | |||||||||
| City: | BARBERTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442033332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306153026 | ||||||||
| FaxNumber: | 3306153033 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/10/2007 | ||||||||
| LastUpdateDate: | 12/10/2007 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | KINZEL | ||||||||
| AuthorizedOfficialFirstName: | ALLYSON | ||||||||
| AuthorizedOfficialMiddleName: | HANCOCK | ||||||||
| AuthorizedOfficialTitleorPosition: | ATTORNEY | ||||||||
| AuthorizedOfficialTelephone: | 7136461351 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.