Healthcare Provider Details

I. General information

NPI: 1295941763
Provider Name (Legal Business Name): ADENA HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 06/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 HOSPITAL RD
CHILLICOTHEE OH
45601-9031
US

IV. Provider business mailing address

272 HOSPITAL RD SUITE 3
CHILLICOTHEE OH
45601-9031
US

V. Phone/Fax

Practice location:
  • Phone: 740-779-8440
  • Fax: 740-779-7488
Mailing address:
  • Phone: 740-779-4460
  • Fax: 740-779-4257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT M ROSENBERGER
Title or Position: CFO
Credential:
Phone: 740-779-7582