Healthcare Provider Details

I. General information

NPI: 1316925332
Provider Name (Legal Business Name): COSHOCTON COUNTY MEMORIAL HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 ORANGE ST
COSHOCTON OH
43812-2229
US

IV. Provider business mailing address

1460 ORANGE ST P.O. BOX 1330
COSHOCTON OH
43812-2229
US

V. Phone/Fax

Practice location:
  • Phone: 740-622-6411
  • Fax:
Mailing address:
  • Phone: 740-622-6411
  • 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: MR. GREGORY M. NOWAK
Title or Position: ADMINISTRATOR
Credential:
Phone: 740-623-4138