MEDICARE: ADENA HEALTH SYSTEM

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	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295912210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADENA HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	272 HOSPITAL RD
Second Line	:	SUITE 3
City	:	CHILLICOTHEE
State	:	OH
Zip	:	45601-9031
Country	:	US
Telephone Number	:	740-779-4460
Fax Number	:	740-779-4257

Provider Business Practice Location Address
First Line	:	536 MIRABEAU ST
Second Line	:
City	:	GREENFIELD
State	:	OH
Zip	:	45123-1457
Country	:	US
Telephone Number	:	937-981-9444
Fax Number	:	937-981-9448

Authorized Official
Title or Position	:	CFO
Name	:	ROBERT M ROSENBERGER
Credential	:
Telephone Number	:	740-779-7582

Provider Enumeration Date	:	01/22/2008
Last Update Date	:	06/03/2014

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Directions to “ADENA HEALTH SYSTEM ” Practice Location

Language	Start Address	Practice Location

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