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General NPI Number Information
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NPI Number | 1154321289
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Entity Type | Organization
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Legal Business Name | DEFIANCE REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1200 RALSTON AVE
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City | DEFIANCE
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State | OH
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Zip | 43512-1396
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Country | US
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Telephone | 419-291-0349
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Fax | 419-534-2828
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Provider Business Mailing Address
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Address Line | PO BOX 632927
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City | CINCINNATI
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State | OH
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Zip | 45263-2927
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Country | US
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Telephone | 419-291-0349
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Fax | 419-534-2828
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Authorized Official
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Title or Position | CFO
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Name | RON WACHSMAN
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Credential |
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Telephone | 419-291-0349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 1160
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License Number State | OH
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