Healthcare Provider Details

I. General information

NPI: 1659371615
Provider Name (Legal Business Name): FOSTORIA HOSPITAL ASSOCIATION
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

501 VAN BUREN ST
FOSTORIA OH
44830-1593
US

IV. Provider business mailing address

PO BOX 632982
CINCINNATI OH
45263-2982
US

V. Phone/Fax

Practice location:
  • Phone: 800-477-4035
  • Fax:
Mailing address:
  • Phone: 800-477-4035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number1195
License Number StateOH

VIII. Authorized Official

Name: KEVIN SHARP
Title or Position: VP REV CYCLE
Credential:
Phone: 567-585-7576