Healthcare Provider Details
I. General information
NPI: 1124026638
Provider Name (Legal Business Name): MARION HEALTH SYSTEMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2005
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1050 DELAWARE AVE
MARION OH
43302-6416
US
IV. Provider business mailing address
1050 DELAWARE AVE
MARION OH
43302-6416
US
V. Phone/Fax
- Phone: 740-383-8000
- Fax: 740-375-8106
- Phone: 740-383-8000
- Fax: 740-375-8106
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAVID
PAUL
MILLER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 740-383-7922