Healthcare Provider Details
I. General information
NPI: 1467639336
Provider Name (Legal Business Name): ADENA HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/23/2008
Last Update Date: 06/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4439 STATE ROUTE 159 SUITE 120
CHILLICOTHEE OH
45601-8207
US
IV. Provider business mailing address
272 HOSPITAL RD SUITE 3
CHILLICOTHEE OH
45601-9031
US
V. Phone/Fax
- Phone: 740-779-7275
- Fax: 740-779-7279
- Phone: 740-779-4460
- Fax: 740-779-4257
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
M
ROSENBERGER
Title or Position: CFO
Credential:
Phone: 740-779-7582