Healthcare Provider Details

I. General information

NPI: 1801072178
Provider Name (Legal Business Name): HENRY COUNTY HOSPITAL PHYSICIANS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 03/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E RIVERVIEW AVE
NAPOLEON OH
43545-9805
US

IV. Provider business mailing address

1600 E RIVERVIEW AVE
NAPOLEON OH
43545-9805
US

V. Phone/Fax

Practice location:
  • Phone: 419-592-4015
  • Fax: 419-591-3855
Mailing address:
  • Phone: 419-592-4015
  • Fax: 419-591-3855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MARY WILSON
Title or Position: PFS MGR
Credential:
Phone: 419-591-3836