Provider Demographics
NPI:1033263835
Name:HOCKING VALLEY COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:HOCKING VALLEY COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-380-8389
Mailing Address - Street 1:601 STATE ROUTE 664 N
Mailing Address - Street 2:P.O. BOX 966
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-8541
Mailing Address - Country:US
Mailing Address - Phone:740-380-8000
Mailing Address - Fax:740-385-7458
Practice Address - Street 1:601 STATE ROUTE 664 N
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138-8541
Practice Address - Country:US
Practice Address - Phone:740-380-8000
Practice Address - Fax:740-385-7458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH36Z330Medicare Oscar/Certification