Healthcare Provider Details

I. General information

NPI: 1124088794
Provider Name (Legal Business Name): CRANDALL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S 15TH ST
SEBRING OH
44672-2050
US

IV. Provider business mailing address

800 S 15TH ST
SEBRING OH
44672-2050
US

V. Phone/Fax

Practice location:
  • Phone: 330-938-6126
  • Fax: 330-938-7406
Mailing address:
  • Phone: 330-938-6126
  • Fax: 330-938-7406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID J. MANNION
Title or Position: CONTROLLER
Credential:
Phone: 330-938-6126