Provider Demographics
NPI:1801045406
Name:KNOX COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:KNOX COMMUNITY HOSPITAL
Other - Org Name:PHYSICIAN PRACTICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AMBROSIANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-393-9000
Mailing Address - Street 1:1320 COSHOCTON AVE
Mailing Address - Street 2:STE F
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-6400
Mailing Address - Country:US
Mailing Address - Phone:740-393-9111
Mailing Address - Fax:740-399-3158
Practice Address - Street 1:1330 COSHOCTON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-1440
Practice Address - Country:US
Practice Address - Phone:740-393-5537
Practice Address - Fax:740-393-5577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center