Basic Information
| Provider Information | |||||||||
| NPI: | 1902940042 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BROWN COUNTY GENERAL HOSPITAL | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BROWN COUNTY REGIONAL HEALTHCARE-BETHEL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 N. UNION STREET | ||||||||
| Address2: | |||||||||
| City: | BETHEL | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137349050 | ||||||||
| FaxNumber: | 5137349051 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 N. UNION STREET | ||||||||
| Address2: | |||||||||
| City: | BETHEL | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137349050 | ||||||||
| FaxNumber: | 5137349051 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | FELS | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
| AuthorizedOfficialMiddleName: | J. | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9373787806 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 1115 | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1037667 | 05 | OH | MEDICAID |