Provider Demographics
NPI:1962488411
Name:SCCI HOSPITAL MANSFIELD INC
Entity Type:Organization
Organization Name:SCCI HOSPITAL MANSFIELD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT QUALITY & COMPLIANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:RN MBA
Authorized Official - Phone:713-807-8686
Mailing Address - Street 1:7333 NORTH FREEWAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076
Mailing Address - Country:US
Mailing Address - Phone:713-807-8686
Mailing Address - Fax:713-807-8604
Practice Address - Street 1:335 GLESSNER AVE
Practice Address - Street 2:5TH FLOOR
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903
Practice Address - Country:US
Practice Address - Phone:419-526-0777
Practice Address - Fax:419-526-0929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1426282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2143504Medicaid
OH000000322141OtherBLUE CROSS
OH2143504Medicaid