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General NPI Number Information
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NPI Number | 1063764371
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Entity Type | Organization
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Legal Business Name | EAST LIVERPOOL CITY HOSPITAL
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Dates
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Enumeration Date | 10/10/2012
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Last Update Date | 10/10/2012
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Provider Practice Location Address
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Address Line | 425 W 5TH ST
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-2405
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Country | US
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Telephone | 330-386-2014
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Fax |
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Provider Business Mailing Address
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Address Line | 425 W 5TH ST
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-2405
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Country | US
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Telephone | 330-386-2014
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | MARCUS STANTON COSPER
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Credential | PA-C
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Telephone | 330-507-2988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 003499
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License Number State | OH
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