Basic Information
| Provider Information | |||||||||
| NPI: | 1871737494 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FOSTORIA COMMUNITY HOSPTIAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 633218 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452633218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194366648 | ||||||||
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| Practice Location | |||||||||
| Address1: | 501 VAN BUREN ST | ||||||||
| Address2: | |||||||||
| City: | FOSTORIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448301534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194357734 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2009 | ||||||||
| LastUpdateDate: | 04/27/2009 | ||||||||
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| AuthorizedOfficialLastName: | SWINT | ||||||||
| AuthorizedOfficialFirstName: | KEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP OF FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 4194366648 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 05086C | 01 | PARAMOUNT | OTHER |