Provider Demographics
NPI:1255359568
Name:FISHER-TITUS MEDICAL CENTER
Entity type:Organization
Organization Name:FISHER-TITUS MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR/FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-668-8101
Mailing Address - Street 1:272 BENEDICT AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2374
Mailing Address - Country:US
Mailing Address - Phone:419-668-8101
Mailing Address - Fax:419-663-6036
Practice Address - Street 1:265 BENEDICT AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2308
Practice Address - Country:US
Practice Address - Phone:419-668-0099
Practice Address - Fax:419-663-5818
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FISHER-TITUS MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-17
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========00OtherOHIO BWC PROVIDER #
OH0605625Medicare ID - Type UnspecifiedOHIO MEDICAID PROVIDER #
OH=========00OtherOHIO BWC PROVIDER #