Healthcare Provider Details

I. General information

NPI: 1881092443
Provider Name (Legal Business Name): DEFIANCE HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2014
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 RALSTON AVE
DEFIANCE OH
43512-1396
US

IV. Provider business mailing address

PO BOX 632927
CINCINNATI OH
45263-2927
US

V. Phone/Fax

Practice location:
  • Phone: 419-783-6955
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: KEVIN SHARP
Title or Position: VICE PRESIDENT, REVENUE CYCLE
Credential:
Phone: 567-585-7576