Provider Demographics
NPI:1578650222
Name:TRUMBULL MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:TRUMBULL MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP AND COO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SPIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:FACHE
Authorized Official - Phone:330-841-9820
Mailing Address - Street 1:1350 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6608
Mailing Address - Country:US
Mailing Address - Phone:330-841-9820
Mailing Address - Fax:330-841-9281
Practice Address - Street 1:1350 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6608
Practice Address - Country:US
Practice Address - Phone:330-841-9820
Practice Address - Fax:330-841-9281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06-2357273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8895843Medicaid
OH8895843Medicaid