Provider Demographics
NPI:1467538116
Name:CITY OF WOOSTER
Entity Type:Organization
Organization Name:CITY OF WOOSTER
Other - Org Name:DBA WOOSTER COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER, PFS
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-263-8288
Mailing Address - Street 1:1761 BEALL AVE
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2342
Mailing Address - Country:US
Mailing Address - Phone:330-263-8100
Mailing Address - Fax:330-263-8525
Practice Address - Street 1:1761 BEALL AVE
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2342
Practice Address - Country:US
Practice Address - Phone:330-263-8100
Practice Address - Fax:330-263-8525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory