Healthcare Provider Details

I. General information

NPI: 1760281026
Provider Name (Legal Business Name): CITY HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 MAIN ST
WELLSVILLE OH
43968-1662
US

IV. Provider business mailing address

601 MAIN ST
WELLSVILLE OH
43968-1662
US

V. Phone/Fax

Practice location:
  • Phone: 330-362-4799
  • Fax:
Mailing address:
  • Phone: 330-362-4799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER DOAN
Title or Position: MANAGING ASSOCIATE GENERAL COUNSEL
Credential:
Phone: 310-259-4706