Provider Demographics
NPI:1184688194
Name:JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL
Other - Org Name:JTDMH INPATIENT REHABILITATION UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCIAL SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:POHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-394-3335
Mailing Address - Street 1:200 SAINT CLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:ST MARYS
Mailing Address - State:OH
Mailing Address - Zip Code:45885-2400
Mailing Address - Country:US
Mailing Address - Phone:419-394-3335
Mailing Address - Fax:419-394-8485
Practice Address - Street 1:200 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:ST MARYS
Practice Address - State:OH
Practice Address - Zip Code:45885-2400
Practice Address - Country:US
Practice Address - Phone:419-394-3335
Practice Address - Fax:419-394-8485
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-14
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4434508Medicaid
OH36T032Medicare Oscar/Certification