Healthcare Provider Details

I. General information

NPI: 1356366991
Provider Name (Legal Business Name): AULTMAN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 10/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 6TH ST SW
CANTON OH
44710-1702
US

IV. Provider business mailing address

2600 6TH ST SW
CANTON OH
44710-1702
US

V. Phone/Fax

Practice location:
  • Phone: 330-452-9911
  • Fax:
Mailing address:
  • Phone: 330-452-9911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARK WRIGHT
Title or Position: VP
Credential:
Phone: 330-452-9911