Provider Demographics
NPI:1114136900
Name:MAHONING VALLEY HOSPITAL, INC.
Entity Type:Organization
Organization Name:MAHONING VALLEY HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SENCHAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-675-5055
Mailing Address - Street 1:1350 E MARKET ST
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6608
Mailing Address - Country:US
Mailing Address - Phone:330-675-5055
Mailing Address - Fax:330-675-5059
Practice Address - Street 1:1350 E MARKET ST
Practice Address - Street 2:9TH FLOOR
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6608
Practice Address - Country:US
Practice Address - Phone:330-675-5055
Practice Address - Fax:330-675-5059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNOT APPLICABLE282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2142309Medicaid
OH2142309Medicaid