Provider Demographics
NPI:1871606921
Name:THE UNION HOSPITAL ASSOCIATION
Entity type:Organization
Organization Name:THE UNION HOSPITAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF ACCOUNTING OFFICER AND CONTRO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGVILLE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:216-636-7416
Mailing Address - Street 1:659 BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-2026
Mailing Address - Country:US
Mailing Address - Phone:330-343-3311
Mailing Address - Fax:
Practice Address - Street 1:659 BOULEVARD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-2026
Practice Address - Country:US
Practice Address - Phone:330-343-3311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1493320OtherUMWA PROVIDER#
OH6460630OtherAETNA PROVIDER #
OH000000186077OtherBC/BS PROVIDER #
OH8957759Medicaid
OH000000186077OtherBC/BS PROVIDER #
OH=========025OtherMEDICAL MUTUAL OF OH PROV
OH1493320OtherUMWA PROVIDER#
CF6648Medicare PIN