Provider Demographics
NPI:1548260581
Name:FOSTORIA COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:FOSTORIA COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VP
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:WACHSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-824-7585
Mailing Address - Street 1:PO BOX 632982
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-2982
Mailing Address - Country:US
Mailing Address - Phone:800-477-4035
Mailing Address - Fax:419-882-1352
Practice Address - Street 1:501 VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:FOSTORIA
Practice Address - State:OH
Practice Address - Zip Code:44830-1593
Practice Address - Country:US
Practice Address - Phone:800-477-4035
Practice Address - Fax:419-882-1352
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROMEDICA HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-29
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1195282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2888924Medicaid
OH360099Medicare ID - Type UnspecifiedMEDICARE PROVIDER FOSTORI