Basic Information
| Provider Information | |||||||||
| NPI: | 1922040591 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRUMBULL MEMORIAL HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1350 E MARKET ST | ||||||||
| Address2: | |||||||||
| City: | WARREN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444836608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308419820 | ||||||||
| FaxNumber: | 3308419281 | ||||||||
| Practice Location | |||||||||
| Address1: | 1350 E MARKET ST | ||||||||
| Address2: | |||||||||
| City: | WARREN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444836608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308419820 | ||||||||
| FaxNumber: | 3308419281 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SPIEGEL | ||||||||
| AuthorizedOfficialFirstName: | KEVIN | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE VP AND COO | ||||||||
| AuthorizedOfficialTelephone: | 3308419820 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | FACHE | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | X | Hospitals | General Acute Care Hospital | 273R00000X | X | Hospital Units | Psychiatric Unit |
ID Information
| ID | Type | State | Issuer | Description | 8895843 | 05 | OH | MEDICAID |