Healthcare Provider Details

I. General information

NPI: 1639133002
Provider Name (Legal Business Name): JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SAINT CLAIR AVE
SAINT MARYS OH
45885-2400
US

IV. Provider business mailing address

200 SAINT CLAIR AVE
SAINT MARYS OH
45885-2400
US

V. Phone/Fax

Practice location:
  • Phone: 419-394-3335
  • Fax: 419-394-8485
Mailing address:
  • Phone: 419-394-3335
  • Fax: 419-394-8485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberHOS020623650
License Number StateOH

VIII. Authorized Official

Name: TRICIA ANN POHL
Title or Position: CFO
Credential:
Phone: 419-394-3387