Provider Demographics
NPI:1215907522
Name:GALION COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:GALION COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:DRAIME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-468-0501
Mailing Address - Street 1:269 PORTLANDWAY SOUTH
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-2312
Mailing Address - Country:US
Mailing Address - Phone:419-468-4841
Mailing Address - Fax:419-468-2381
Practice Address - Street 1:269 PORTLANDWAY SOUTH
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-2312
Practice Address - Country:US
Practice Address - Phone:419-468-4841
Practice Address - Fax:419-468-2381
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GALION COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-26
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 207R00000X, 208000000X, 208M00000X, 363A00000X, 363L00000X
OH1132282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical AccessGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH197558Medicaid
OH2570730Medicaid
OH3031507Medicaid
OH2570767Medicaid
OH2570794Medicaid
OH000000157580OtherANTHEM BCBS
OH2570712Medicaid
OH2570794Medicaid
OH2570730Medicaid