Provider Demographics
NPI:1598765000
Name:DEFIANCE HOSPITAL INC.
Entity Type:Organization
Organization Name:DEFIANCE HOSPITAL INC.
Other - Org Name:DEFIANCE REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP REV CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:567-585-7576
Mailing Address - Street 1:PO BOX 632927
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-2927
Mailing Address - Country:US
Mailing Address - Phone:800-477-4035
Mailing Address - Fax:419-882-1352
Practice Address - Street 1:1200 RALSTON AVE
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-1396
Practice Address - Country:US
Practice Address - Phone:800-477-4035
Practice Address - Fax:419-882-1352
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROMEDICA HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-26
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1160273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2079503Medicaid
OH36M328Medicare Oscar/Certification