Provider Demographics
NPI:1255592556
Name:GCH HEALTH SERVICES
Entity type:Organization
Organization Name:GCH HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:V
Authorized Official - Last Name:MELARAGNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-468-0501
Mailing Address - Street 1:330 N SELTZER ST
Mailing Address - Street 2:
Mailing Address - City:CRESTLINE
Mailing Address - State:OH
Mailing Address - Zip Code:44827-1403
Mailing Address - Country:US
Mailing Address - Phone:419-683-3200
Mailing Address - Fax:
Practice Address - Street 1:330 N SELTZER ST
Practice Address - Street 2:
Practice Address - City:CRESTLINE
Practice Address - State:OH
Practice Address - Zip Code:44827-1403
Practice Address - Country:US
Practice Address - Phone:419-683-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GALION COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35075010B207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2570730Medicaid