Healthcare Provider Details

I. General information

NPI: 1013909092
Provider Name (Legal Business Name): HEALTH SERVICES OF COSHOCTON COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 06/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 S 4TH ST
COSHOCTON OH
43812-2019
US

IV. Provider business mailing address

230 S 4TH ST
COSHOCTON OH
43812-2019
US

V. Phone/Fax

Practice location:
  • Phone: 740-622-7311
  • Fax: 740-622-7310
Mailing address:
  • Phone: 740-622-7311
  • Fax: 740-622-7310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number0014-HSP
License Number StateOH

VIII. Authorized Official

Name: ANGELA M TAYLOR
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 740-622-7311