Provider Demographics
NPI:1275607772
Name:MEMORIAL HOSPITAL OF UNION COUNTY
Entity Type:Organization
Organization Name:MEMORIAL HOSPITAL OF UNION COUNTY
Other - Org Name:MEMORIAL HOSPITAL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:A
Authorized Official - Last Name:EHLERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-578-2228
Mailing Address - Street 1:500 LONDON AVE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-5512
Mailing Address - Country:US
Mailing Address - Phone:937-644-3211
Mailing Address - Fax:
Practice Address - Street 1:171 MOREY DR
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-1644
Practice Address - Country:US
Practice Address - Phone:937-644-3211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0383553Medicaid
OH36-7146Medicare UPIN