Provider Demographics
NPI:1538304050
Name:OHIO VALLEY MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:OHIO VALLEY MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-717-2262
Mailing Address - Street 1:100 W. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45502
Mailing Address - Country:US
Mailing Address - Phone:937-521-3900
Mailing Address - Fax:937-521-3910
Practice Address - Street 1:100 W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45502
Practice Address - Country:US
Practice Address - Phone:937-521-3900
Practice Address - Fax:937-521-3910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
OH#1487282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH36-0355Medicare UPIN