Basic Information
| Provider Information | |||||||||
| NPI: | 1831137827 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BLANCHARD VALLEY REGIONAL HEALTH CENTER | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BLUFFTON HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 SOUTH MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458401239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193589010 | ||||||||
| FaxNumber: | 4194235550 | ||||||||
| Practice Location | |||||||||
| Address1: | 139 GARAU ST | ||||||||
| Address2: | |||||||||
| City: | BLUFFTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458171027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193589010 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 02/17/2014 | ||||||||
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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 | 282NC0060X | 1101 | OH | Y | Hospitals | General Acute Care Hospital | Critical Access |
ID Information
| ID | Type | State | Issuer | Description | 1101 | 01 | OH | DEPT OF HEALTH HOSPITAL # | OTHER | 2497678 | 05 | OH | MEDICAID |