Provider Demographics
NPI:1619592763
Name:KNOX COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:KNOX COMMUNITY HOSPITAL
Other - Org Name:KCH OUTPATIENT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AMBROSIANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-393-9623
Mailing Address - Street 1:1330 COSHOCTON AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-1495
Mailing Address - Country:US
Mailing Address - Phone:740-326-3485
Mailing Address - Fax:740-326-3486
Practice Address - Street 1:1330 COSHOCTON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-1495
Practice Address - Country:US
Practice Address - Phone:740-393-9665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy