Provider Demographics
NPI:1639470388
Name:HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION
Entity type:Organization
Organization Name:HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:BAER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-393-6101
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-0070
Mailing Address - Country:US
Mailing Address - Phone:937-393-1129
Mailing Address - Fax:937-393-1658
Practice Address - Street 1:8900 STATE ROUTE 134
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:OH
Practice Address - Zip Code:45142-9272
Practice Address - Country:US
Practice Address - Phone:937-364-2346
Practice Address - Fax:937-364-6960
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGHLAND DISTRICT HOSPITAL FOUNDATION CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health