Healthcare Provider Details

I. General information

NPI: 1699775726
Provider Name (Legal Business Name): DEFIANCE HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2005
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: 800-477-4035
  • Fax: 419-882-1352
Mailing address:
  • Phone: 800-477-4035
  • Fax: 419-882-1352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number1160
License Number StateOH

VIII. Authorized Official

Name: KEVIN SHARP
Title or Position: VP REV CYCLE
Credential:
Phone: 675-857-5765