Provider Demographics
NPI:1912489436
Name:MASSILLON REGIONAL MEDICAL CENTER
Entity type:Organization
Organization Name:MASSILLON REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-801-3501
Mailing Address - Street 1:875 8TH ST NE
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-8503
Mailing Address - Country:US
Mailing Address - Phone:865-801-3501
Mailing Address - Fax:
Practice Address - Street 1:875 8TH ST NE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646
Practice Address - Country:US
Practice Address - Phone:865-801-3501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
No273R00000XHospital UnitsPsychiatric Unit
No291U00000XLaboratoriesClinical Medical Laboratory
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No331L00000XSuppliersBlood Bank
No333600000XSuppliersPharmacy