Healthcare Provider Details

I. General information

NPI: 1487681524
Provider Name (Legal Business Name): AULTMAN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 WOODLAWN AVE NW
CANTON OH
44708-1423
US

IV. Provider business mailing address

2600 SIXTH ST SW
CANTON OH
44710-1702
US

V. Phone/Fax

Practice location:
  • Phone: 303-479-4800
  • Fax:
Mailing address:
  • Phone: 330-452-9911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

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