Healthcare Provider Details

I. General information

NPI: 1912184888
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: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4439 STATE ROUTE 159 SUITE 280
CHILLICOTHEE OH
45601-8207
US

IV. Provider business mailing address

272 HOSPITAL ROAD SUITE 3
CHILLICOTHEE OH
45601
US

V. Phone/Fax

Practice location:
  • Phone: 740-779-4370
  • Fax: 740-779-4379
Mailing address:
  • Phone: 740-779-8234
  • Fax: 740-779-7477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

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