# MARY RUTAN HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MARY RUTAN HOSPITAL
- **Other names:** Mad River Family Practice
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003875949
- **Legal business name:** MARY RUTAN HOSPITAL
- **Authorized official:** RON CARMIN (VP/FINANCE)
- **Authorized official phone:** (937) 592-4015

## Contact information

- **Practice address:** 4879 US HIGHWAY 68 S, WEST LIBERTY, OH 43357-9525
- **Practice address phone:** (937) 599-1411
- **Practice address fax:** (937) 465-9945
- **Mailing address:** 4879 US HIGHWAY 68 S, WEST LIBERTY, OH 43357-9525
- **Mailing address phone:** (937) 599-1411
- **Mailing address fax:** (937) 465-9945

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/20/2006
- **Last updated:** 07/10/2007