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General NPI Number Information
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NPI Number | 1619120995
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Entity Type | Organization
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Legal Business Name | FOSTORIA HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 10/30/2008
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Last Update Date | 10/30/2008
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Provider Practice Location Address
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Address Line | 601 PARKWAY DR
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City | FOSTORIA
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State | OH
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Zip | 44830-1592
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Country | US
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Telephone | 419-435-1832
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Fax | 419-435-9511
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Provider Business Mailing Address
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Address Line | 601 PARKWAY DR
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City | FOSTORIA
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State | OH
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Zip | 44830-1592
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Country | US
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Telephone | 419-435-1832
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Fax | 419-435-9511
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Authorized Official
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Title or Position | PRESIDENT, FOSTORIA HOSPITAL ASSOC
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Name | MR. TIMOTHY JAKACKI
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Credential |
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Telephone | 41994366649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 0164HSP
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License Number State | OH
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