Provider Demographics
NPI:1437321239
Name:COMMUNITY AND RURAL HEALTH SERVICES
Entity Type:Organization
Organization Name:COMMUNITY AND RURAL HEALTH SERVICES
Other - Org Name:BIRCHARD MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF HUMAN RESOURCES
Authorized Official - Prefix:MS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-334-8943
Mailing Address - Street 1:410 BIRCHARD AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-2967
Mailing Address - Country:US
Mailing Address - Phone:419-334-8943
Mailing Address - Fax:419-334-8619
Practice Address - Street 1:418 BIRCHARD AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-2967
Practice Address - Country:US
Practice Address - Phone:419-334-8943
Practice Address - Fax:419-334-8619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH361843Medicare Oscar/Certification