Provider Demographics
NPI:1154523827
Name:BARBERTON CITIZENS HOSPITAL
Entity type:Organization
Organization Name:BARBERTON CITIZENS HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED ATHLETIC TRAINER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUSTINE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:ATC
Authorized Official - Phone:330-615-5000
Mailing Address - Street 1:363 HIGHLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281
Mailing Address - Country:US
Mailing Address - Phone:330-336-0182
Mailing Address - Fax:
Practice Address - Street 1:28 CONSERVATORY DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44213
Practice Address - Country:US
Practice Address - Phone:330-615-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000997282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital