Healthcare Provider Details

I. General information

NPI: 1376531533
Provider Name (Legal Business Name): SHELBY COUNTY MEMORIAL HOSPITAL ASSOCIATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1083 FAIRINGTON DR
SIDNEY OH
45365-8130
US

IV. Provider business mailing address

915 MICHIGAN ST
SIDNEY OH
45365-2401
US

V. Phone/Fax

Practice location:
  • Phone: 937-498-5495
  • Fax: 937-498-4669
Mailing address:
  • Phone: 937-498-5495
  • Fax: 937-498-4669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number0037HSP
License Number StateOH

VIII. Authorized Official

Name: MRS. JOANN SCOTT
Title or Position: DIRECTOR
Credential:
Phone: 937-498-9335