Provider Demographics
NPI:1447342514
Name:WILSON MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:WILSON MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNP
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GARIETY
Authorized Official - Suffix:
Authorized Official - Credentials:FAMILY NURSE PRACTIT
Authorized Official - Phone:937-498-5509
Mailing Address - Street 1:915 WEST MICHIGAN STREET
Mailing Address - Street 2:OCCUPATIONAL HEALTH
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-2491
Mailing Address - Country:US
Mailing Address - Phone:937-498-5545
Mailing Address - Fax:937-498-5544
Practice Address - Street 1:915 WEST MICHIGAN STREET
Practice Address - Street 2:OCCUPATIONAL HEALTH
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-2491
Practice Address - Country:US
Practice Address - Phone:937-498-5545
Practice Address - Fax:937-498-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-06444282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital