Provider Demographics
NPI: | 1174605943 |
---|---|
Name: | THE UNION HOSPITAL ASSOCIATION |
Entity type: | Organization |
Organization Name: | THE UNION HOSPITAL ASSOCIATION |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE VP CHIEF FINANCE OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DENNIS |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LARAWAY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 216-445-1343 |
Mailing Address - Street 1: | 6801 BRECKSVILLE RD |
Mailing Address - Street 2: | STE 20, ATTN: DPC RK2-7 |
Mailing Address - City: | INDPENDENCE |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 44131-5062 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 320 OXFORD ST |
Practice Address - Street 2: | |
Practice Address - City: | DOVER |
Practice Address - State: | OH |
Practice Address - Zip Code: | 44622-1963 |
Practice Address - Country: | US |
Practice Address - Phone: | 330-343-6909 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-10-20 |
Last Update Date: | 2025-08-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
OH | 0679118 | Medicaid | |
OH | 0679118 | Medicaid |