Provider Demographics
NPI:1184681280
Name:THE COMMUNITY HOSPITAL OF SPRINGFIELD AND CLARK COUNTY
Entity Type:Organization
Organization Name:THE COMMUNITY HOSPITAL OF SPRINGFIELD AND CLARK COUNTY
Other - Org Name:COMMUNITY HOPSITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:WIENER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-328-9515
Mailing Address - Street 1:2615 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-1412
Mailing Address - Country:US
Mailing Address - Phone:937-325-0531
Mailing Address - Fax:
Practice Address - Street 1:2615 E HIGH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-1412
Practice Address - Country:US
Practice Address - Phone:937-325-0531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE COMMUNITY HOSPITAL OF SPRINGFIELD AND CLARK COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-01
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8348569Medicaid
OH8348569Medicaid