Provider Demographics
NPI:1578902870
Name:MIAMI VALLEY HOSPITAL
Entity Type:Organization
Organization Name:MIAMI VALLEY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STUDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUFUS
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN DYKE
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:208-241-5997
Mailing Address - Street 1:1800 E SHELBY ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-2022
Mailing Address - Country:US
Mailing Address - Phone:208-241-5997
Mailing Address - Fax:
Practice Address - Street 1:1800 E SHELBY ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-2022
Practice Address - Country:US
Practice Address - Phone:208-241-5997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital