Provider Demographics
NPI:1104934553
Name:MERCER COUNTY JOINT TOWNSHIP COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:MERCER COUNTY JOINT TOWNSHIP COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO/COO
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:DINGLEDINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-678-5104
Mailing Address - Street 1:909 E WAYNE ST STE 126
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-3304
Mailing Address - Country:US
Mailing Address - Phone:419-584-0143
Mailing Address - Fax:419-584-1783
Practice Address - Street 1:909 E WAYNE ST STE 126
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-3304
Practice Address - Country:US
Practice Address - Phone:419-584-0143
Practice Address - Fax:419-584-1783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-27
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0024968Medicaid
OH367089Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
OH=========01OtherWORKERS COMP PROVIDER #