Provider Demographics
NPI:1851665566
Name:CITY OF WOOSTER
Entity Type:Organization
Organization Name:CITY OF WOOSTER
Other - Org Name:WOOSTER COMMUNITY HOSPITAL SNF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-263-8148
Mailing Address - Street 1:1761 BEALL AVE
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2342
Mailing Address - Country:US
Mailing Address - Phone:330-263-8100
Mailing Address - Fax:330-263-8497
Practice Address - Street 1:1761 BEALL AVE
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2342
Practice Address - Country:US
Practice Address - Phone:330-263-8100
Practice Address - Fax:330-263-8497
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF WOOSTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-27
Last Update Date:2013-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH366405Medicare Oscar/Certification