Healthcare Provider Details
I. General information
NPI: 1174586150
Provider Name (Legal Business Name): MEDINA HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/10/2006
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3724 CENTER RD
BRUNSWICK OH
44212-4400
US
IV. Provider business mailing address
1000 E WASHINGTON ST
MEDINA OH
44256-2170
US
V. Phone/Fax
- Phone: 330-273-5490
- Fax:
- Phone: 330-725-1000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DENNIS
LARAWAY
Title or Position: EXECUTIVE VP CHIEF FINANCE OFFICER
Credential:
Phone: 216-445-1343