Provider Demographics
NPI:1427022748
Name:ASHTABULA COUNTY MEDICAL CENTER
Entity Type:Organization
Organization Name:ASHTABULA COUNTY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR PFS/REG
Authorized Official - Prefix:MISS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOCEVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-997-6665
Mailing Address - Street 1:2420 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-4954
Mailing Address - Country:US
Mailing Address - Phone:440-997-6665
Mailing Address - Fax:
Practice Address - Street 1:2420 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-4954
Practice Address - Country:US
Practice Address - Phone:440-997-6665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36S125273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH36S125Medicare Oscar/Certification