Healthcare Provider Details

I. General information

NPI: 1346247350
Provider Name (Legal Business Name): SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 CLARK ST
CAMBRIDGE OH
43725-9614
US

IV. Provider business mailing address

1341 CLARK ST
CAMBRIDGE OH
43725-9614
US

V. Phone/Fax

Practice location:
  • Phone: 740-439-8179
  • Fax: 740-439-8175
Mailing address:
  • Phone: 740-439-8179
  • Fax: 740-439-8175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: WENDY ELLIOTT
Title or Position: CEO
Credential:
Phone: 740-420-8075