Healthcare Provider Details

I. General information

NPI: 1972573202
Provider Name (Legal Business Name): GALION COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 04/09/2014
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

269 PORTLANDWAY SOUTH
GALION OH
44833-2312
US

V. Phone/Fax

Practice location:
  • Phone: 419-468-0824
  • Fax: 419-468-8579
Mailing address:
  • Phone: 419-468-4841
  • Fax: 419-468-2381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number4743
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1132
License Number StateOH

VIII. Authorized Official

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