Provider Demographics
NPI:1598862971
Name:BLANCHARD VALLEY REGIONAL HEALTH CENTER
Entity type:Organization
Organization Name:BLANCHARD VALLEY REGIONAL HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:CYTLAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-423-5497
Mailing Address - Street 1:1900 SOUTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1214
Mailing Address - Country:US
Mailing Address - Phone:419-423-5262
Mailing Address - Fax:419-423-5550
Practice Address - Street 1:1000 E MAIN CROSS ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-6317
Practice Address - Country:US
Practice Address - Phone:419-423-5184
Practice Address - Fax:419-423-5519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
36-2336Medicare ID - Type Unspecified
OH0759666Medicare ID - Type Unspecified