Provider Demographics
NPI:1003115585
Name:KNOX COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:KNOX COMMUNITY HOSPITAL
Other - Org Name:KNOX COMMUNITY HOSPITAL URGENT CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AMBROSIANI
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:740-393-9178
Mailing Address - Street 1:1490 COSHOCTON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-6099
Mailing Address - Country:US
Mailing Address - Phone:740-393-9111
Mailing Address - Fax:740-399-3161
Practice Address - Street 1:1330 COSHOCTON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-1440
Practice Address - Country:US
Practice Address - Phone:740-393-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care