Provider Demographics
NPI:1639131535
Name:SALEM COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:SALEM COMMUNITY HOSPITAL
Other - Org Name:SALEM REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HACKSTEDDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-332-7214
Mailing Address - Street 1:1995 EAST STATE STREET
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460
Mailing Address - Country:US
Mailing Address - Phone:330-332-7670
Mailing Address - Fax:330-332-7476
Practice Address - Street 1:1995 EAST STATE STREET
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460
Practice Address - Country:US
Practice Address - Phone:330-332-7670
Practice Address - Fax:330-332-7476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1125282N00000X
282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7654408Medicaid
OH365682OtherSNF MEDICARE
OH0533770001OtherDME MEDICARE
OH0533770001Medicare NSC
OH0533770001OtherDME MEDICARE
OH7654408Medicaid