# CIVISTA MEDICAL CENTER INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992701825
- **Authorized official:** ALBERT ZANGER (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (301) 609-5163

## Contact information

- **Practice address:** 5 GARRETT AVENUE, LA PLATA, MD 20646-1070
- **Practice address phone:** (301) 609-4474
- **Practice address fax:** (301) 609-4411
- **Mailing address:** PO BOX 1070, LA PLATA, MD 20646-1070
- **Mailing address phone:** (301) 609-5163
- **Mailing address fax:** (301) 934-0053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282NR1301X | Rural Acute Care Hospital | — | MD | Yes |

## Other

- **Enumeration date:** 06/24/2005
- **Last updated:** 09/11/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003355200 | — | MD |