Provider Demographics
NPI:1255319208
Name:BELMONT COUNTY PARK HEALTH CENTER
Entity Type:Organization
Organization Name:BELMONT COUNTY PARK HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:ERDOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-695-4925
Mailing Address - Street 1:100 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9738
Mailing Address - Country:US
Mailing Address - Phone:740-695-4925
Mailing Address - Fax:740-695-4915
Practice Address - Street 1:100 PINE AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9738
Practice Address - Country:US
Practice Address - Phone:740-695-4925
Practice Address - Fax:740-695-4915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0899989Medicaid
OH0899989Medicaid