Healthcare Provider Details

I. General information

NPI: 1720488653
Provider Name (Legal Business Name): GALION PHYSICIAN SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2014
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 PORTLAND WAY S
GALION OH
44833-2312
US

IV. Provider business mailing address

332 CONGRESS PARK DR
DAYTON OH
45459-4133
US

V. Phone/Fax

Practice location:
  • Phone: 419-468-0733
  • Fax:
Mailing address:
  • Phone: 937-312-3627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License NumberRN.352282
License Number StateOH

VIII. Authorized Official

Name: JOHN SCHOETTMER
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 419-468-0733