Healthcare Provider Details

I. General information

NPI: 1457398893
Provider Name (Legal Business Name): COMMUNITY HOSPITALS AND WELLNESS CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 E SNYDER AVE
MONTPELIER OH
43543-1251
US

IV. Provider business mailing address

433 W HIGH ST
BRYAN OH
43506-1690
US

V. Phone/Fax

Practice location:
  • Phone: 419-485-3154
  • Fax: 419-485-3833
Mailing address:
  • Phone: 419-636-1131
  • Fax: 419-636-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number StateOH

VIII. Authorized Official

Name: MR. PHILIP L. ENNEN
Title or Position: PRESIDENT
Credential:
Phone: 419-636-1131