Provider Demographics
NPI:1285807115
Name:ADAMS COUNTY HOSPITAL
Entity type:Organization
Organization Name:ADAMS COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETE
Authorized Official - Middle Name:R
Authorized Official - Last Name:DAGENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:937-386-3400
Mailing Address - Street 1:19262 STATE ROUTE 136
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45697
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19262 STATE ROUTE 136
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45697
Practice Address - Country:US
Practice Address - Phone:937-695-0748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADAMS COUNTY REGIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-11
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35083494261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9355131Medicare PIN