Provider Demographics
NPI:1871809848
Name:YOUNGSTOWN OHIO HOSPITAL COMPANY LLC
Entity type:Organization
Organization Name:YOUNGSTOWN OHIO HOSPITAL COMPANY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTH OFFICIAL/DIR BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7488
Mailing Address - Street 1:16964 COLLECTIONS CENTER DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60693-0001
Mailing Address - Country:US
Mailing Address - Phone:330-884-5879
Mailing Address - Fax:330-884-5735
Practice Address - Street 1:500 GYPSY LN
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1315
Practice Address - Country:US
Practice Address - Phone:330-884-5879
Practice Address - Fax:330-884-5735
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YOUNGSTOWN OHIO HOSPITAL COMPANY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH36S141Medicare Oscar/Certification