MEDICARE: TRINITY HOSPITAL TWIN CITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center	2001194	OH

General Provider Information

NPI Number	:	1104265792
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY HOSPITAL TWIN CITY

Provider Business Mailing Address
First Line	:	819 N 1ST ST
Second Line	:
City	:	DENNISON
State	:	OH
Zip	:	44621-1003
Country	:	US
Telephone Number	:	740-922-0000
Fax Number	:	740-922-8042

Provider Business Practice Location Address
First Line	:	110 NORTH WALNUT STREET
Second Line	:
City	:	GNADENHUTTEN
State	:	OH
Zip	:	44629
Country	:	US
Telephone Number	:	740-254-9443
Fax Number	:	740-254-9445

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	ROBIN BROWN
Credential	:
Telephone Number	:	740-922-7450

Provider Enumeration Date	:	06/18/2013
Last Update Date	:	06/18/2013

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