Provider Demographics
NPI:1295840007
Name:HOCKING VALLEY COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:HOCKING VALLEY COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-380-8389
Mailing Address - Street 1:601 STATE ROUTE 664 N
Mailing Address - Street 2:P.O. BOX 966
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-8541
Mailing Address - Country:US
Mailing Address - Phone:740-380-8000
Mailing Address - Fax:740-385-7458
Practice Address - Street 1:601 STATE ROUTE 664 N
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138-8541
Practice Address - Country:US
Practice Address - Phone:740-380-8000
Practice Address - Fax:740-385-7458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000156744OtherANTHEM BLUE CROSS
OH030339300OtherDEPARTMENT OF LABOR
OH3978503Medicaid
OH5000035OtherUNITED HEALTHCARE OF OHIO
OH0500130OtherAETNA
OH=========034OtherMEDICAL MUTUAL OF OHIO
OH=========00OtherBUREAU OF WORKERS COMP