Healthcare Provider Details

I. General information

NPI: 1548254931
Provider Name (Legal Business Name): MARY RUTAN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 PALMER AVENUE
BELLEFONTAINE OH
43311-2298
US

IV. Provider business mailing address

205 PALMER AVENUE
BELLEFONTAINE OH
43311-2298
US

V. Phone/Fax

Practice location:
  • Phone: 937-592-4015
  • Fax:
Mailing address:
  • Phone: 937-592-4015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: CHAD ROSS
Title or Position: PRESIDENT/CEO
Credential:
Phone: 937-592-4015