Provider Demographics
NPI:1013909092
Name:HEALTH SERVICES OF COSHOCTON COUNTY
Entity Type:Organization
Organization Name:HEALTH SERVICES OF COSHOCTON COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-622-7311
Mailing Address - Street 1:230 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-2019
Mailing Address - Country:US
Mailing Address - Phone:740-622-7311
Mailing Address - Fax:740-622-7310
Practice Address - Street 1:230 S 4TH ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-2019
Practice Address - Country:US
Practice Address - Phone:740-622-7311
Practice Address - Fax:740-622-7310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0014-HSP251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0820286Medicaid
OH0820286Medicaid