Provider Demographics
NPI:1508208604
Name:COMMUNITY HEALTH NETWORK LTD
Entity Type:Organization
Organization Name:COMMUNITY HEALTH NETWORK LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:KATHARINE
Authorized Official - Last Name:MARTY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:330-988-4966
Mailing Address - Street 1:2200 BENDEN DR STE 5
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2569
Mailing Address - Country:US
Mailing Address - Phone:330-641-4195
Mailing Address - Fax:330-809-6366
Practice Address - Street 1:2200 BENDEN DR STE 5
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2569
Practice Address - Country:US
Practice Address - Phone:330-464-7156
Practice Address - Fax:330-809-6366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-18
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2186373251E00000X, 164W00000X, 251J00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0160587Medicaid