Provider Demographics
NPI:1467857821
Name:GALION COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:GALION COMMUNITY HOSPITAL
Other - Org Name:AVITA ONTARIO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:D
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:DRAIME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-468-4841
Mailing Address - Street 1:600 RICHLAND MALL STE 202A
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-1246
Mailing Address - Country:US
Mailing Address - Phone:567-307-7570
Mailing Address - Fax:
Practice Address - Street 1:600 RICHLAND MALL STE 202A
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-1246
Practice Address - Country:US
Practice Address - Phone:567-307-7570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GALION COMMUNITY HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-28
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy