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General NPI Number Information
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NPI Number | 1629028600
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Entity Type | Organization
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Legal Business Name | FIRELANDS REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 1925 HAYES AVE
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City | SANDUSKY
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State | OH
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Zip | 44870-4793
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Country | US
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Telephone | 419-557-5177
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Fax | 419-557-5169
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Provider Business Mailing Address
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Address Line | 1925 HAYES AVE
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City | SANDUSKY
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State | OH
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Zip | 44870-4793
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Country | US
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Telephone | 419-557-5177
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Fax | 419-557-5169
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT LEGAL
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Name | MR. ROBERT MOORE
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Credential |
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Telephone | 419-557-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | OH
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