Healthcare Provider Details

I. General information

NPI: 1457312886
Provider Name (Legal Business Name): FIRELANDS REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 12/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 HAYES AVE
SANDUSKY OH
44870-3323
US

IV. Provider business mailing address

1111 HAYES AVE
SANDUSKY OH
44870-3323
US

V. Phone/Fax

Practice location:
  • Phone: 419-557-7400
  • Fax:
Mailing address:
  • Phone: 419-557-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number1165
License Number StateOH

VIII. Authorized Official

Name: MR. DANIEL J MONCHER
Title or Position: EXECUTIVE VICE PRESIDENT & CFO
Credential:
Phone: 419-557-7793