Healthcare Provider Details

I. General information

NPI: 1942461025
Provider Name (Legal Business Name): GALION COMMUNITY HOSPTIAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 04/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 BUCYRUS RD
GALION OH
44833-1509
US

IV. Provider business mailing address

269 PORTLANDWAY SOUTH
GALION OH
44833-2312
US

V. Phone/Fax

Practice location:
  • Phone: 419-468-4220
  • Fax:
Mailing address:
  • Phone: 419-468-4841
  • Fax: 419-468-2381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34004233
License Number StateOH

VIII. Authorized Official

Name: DONALD ERIC DRAIME
Title or Position: CFO
Credential:
Phone: 419-468-0501