Provider Demographics
NPI:1740573310
Name:ADAMS COUNTY HOSPITAL
Entity Type:Organization
Organization Name:ADAMS COUNTY HOSPITAL
Other - Org Name:MANCHESTER SCHOOL BASED HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETE
Authorized Official - Middle Name:R
Authorized Official - Last Name:DAGENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-386-3400
Mailing Address - Street 1:230 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SEAMAN
Mailing Address - State:OH
Mailing Address - Zip Code:45679-8002
Mailing Address - Country:US
Mailing Address - Phone:937-386-3400
Mailing Address - Fax:937-386-3459
Practice Address - Street 1:130 WAYNE FRYE DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45144-9314
Practice Address - Country:US
Practice Address - Phone:937-549-4777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-16
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service