Provider Demographics
NPI:1942267760
Name:VAN WERT COUNTY HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:VAN WERT COUNTY HOSPITAL ASSOCIATION
Other - Org Name:VAN WERT HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SILALAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-238-8870
Mailing Address - Street 1:VAN WERT HEALTH
Mailing Address - Street 2:1250 S WASHINGTON ST
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891-2551
Mailing Address - Country:US
Mailing Address - Phone:419-238-2390
Mailing Address - Fax:419-238-0692
Practice Address - Street 1:VAN WERT HEALTH
Practice Address - Street 2:1250 S WASHINGTON ST
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-2551
Practice Address - Country:US
Practice Address - Phone:419-238-2390
Practice Address - Fax:419-238-0692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherWORKMEN COMPENSATION PHY.
OH3600711OtherMEDICARE CARRIER PROVIDER
OH=========OtherWORKMENS COMPENSATION HOS
OHCK1277OtherMEDICARE RAILROAD
OH=========OtherMEDICAL MUTUAL PHYSICIAN
OH000000184281OtherANTHEM HOSPITAL PROVIDER
OH9027663Medicaid
OH=========OtherMEDICAL MUTUAL HOSPITAL
OH000000030033OtherANTHEM PHYSICIAN BILLING
OH360071Medicare ID - Type UnspecifiedPROVIDER NUMBER