Provider Demographics
NPI:1275715039
Name:BUCYRUS COMMUNITY HOSPITAL LLC
Entity Type:Organization
Organization Name:BUCYRUS COMMUNITY HOSPITAL LLC
Other - Org Name:BUCYRUS COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:D.
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:DRAIME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-468-0501
Mailing Address - Street 1:629 N SANDUSKY AVE
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-1821
Mailing Address - Country:US
Mailing Address - Phone:419-562-4677
Mailing Address - Fax:419-562-5598
Practice Address - Street 1:629 N SANDUSKY AVE
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-1821
Practice Address - Country:US
Practice Address - Phone:419-562-4677
Practice Address - Fax:419-562-5598
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUCYRUS COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-03
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
36Z316Medicare Oscar/Certification