Healthcare Provider Details

I. General information

NPI: 1518733856
Provider Name (Legal Business Name): SALEM COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 05/09/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5002 B MILLENNIAL LANE
CANFIELD OH
44406
US

IV. Provider business mailing address

5002 B MILLENNIAL LANE
CANFIELD OH
44406
US

V. Phone/Fax

Practice location:
  • Phone: 330-332-7642
  • Fax:
Mailing address:
  • Phone: 330-332-7642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANITA A HACKSTEDDE
Title or Position: CEO
Credential: MD
Phone: 330-332-7214