Healthcare Provider Details
I. General information
NPI: 1083696710
Provider Name (Legal Business Name): MEDINA HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/17/2005
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 E WASHINGTON ST
MEDINA OH
44256-2170
US
IV. Provider business mailing address
6801 BRECKSVILLE RD STE 20, ATTN: DPC RK2-7
INDEPENDENCE OH
44131-5062
US
V. Phone/Fax
- Phone: 330-725-1000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DENNIS
LARAWAY
Title or Position: EXECUTIVE VP CHIEF FINANCE OFFICER
Credential:
Phone: 216-445-1343