Provider Demographics
NPI:1326099102
Name:SALEM COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:SALEM COMMUNITY HOSPITAL
Other - Org Name:SALEM REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HACKSTEDDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-332-7214
Mailing Address - Street 1:1995 EAST STATE STREET
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460
Mailing Address - Country:US
Mailing Address - Phone:330-332-7171
Mailing Address - Fax:330-332-7476
Practice Address - Street 1:1995 EAST STATE STREET
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460
Practice Address - Country:US
Practice Address - Phone:330-332-7171
Practice Address - Fax:330-332-7476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH360185OtherSALEM COMM HOSPITAL
OH7654408Medicaid
OH360185OtherSALEM COMM HOSPITAL
OH36-0185Medicare PIN
OH0533770001Medicare NSC