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General NPI Number Information
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NPI Number | 1003875949
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Entity Type | Organization
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Legal Business Name | MARY RUTAN HOSPITAL
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 4879 US HIGHWAY 68 S
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City | WEST LIBERTY
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State | OH
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Zip | 43357-9525
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Country | US
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Telephone | 937-599-1411
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Fax | 937-465-9945
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Provider Business Mailing Address
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Address Line | 4879 US HIGHWAY 68 S
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City | WEST LIBERTY
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State | OH
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Zip | 43357-9525
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Country | US
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Telephone | 937-599-1411
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Fax | 937-465-9945
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Authorized Official
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Title or Position | VP/FINANCE
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Name | RON CARMIN
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Credential |
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Telephone | 937-592-4015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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