Provider Demographics
NPI:1518733856
Name:SALEM COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:SALEM COMMUNITY HOSPITAL
Other - Org Name:ADVANCED RADIOLOGY CENTER-CANFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HACKSTEDDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-332-7214
Mailing Address - Street 1:5002 B MILLENNIAL LANE
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406
Mailing Address - Country:US
Mailing Address - Phone:330-332-7642
Mailing Address - Fax:
Practice Address - Street 1:5002 B MILLENNIAL LANE
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406
Practice Address - Country:US
Practice Address - Phone:330-332-7642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SALEM COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-28
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Multi-Specialty