Healthcare Provider Details

I. General information

NPI: 1164479754
Provider Name (Legal Business Name): MAHONING VALLEY HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 12/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8049 SOUTH AVE
BOARDMAN OH
44512-6154
US

IV. Provider business mailing address

8049 SOUTH AVE
BOARDMAN OH
44512-6154
US

V. Phone/Fax

Practice location:
  • Phone: 330-726-5000
  • Fax: 330-726-5053
Mailing address:
  • Phone: 330-726-5000
  • Fax: 330-726-5053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License NumberNOT APPLICABLE
License Number StateOH

VIII. Authorized Official

Name: MR. MICHAEL S SENCHAK
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 330-675-5055