Organization
MARY RUTAN HOSPITAL
Active
Parent organization
MARY RUTAN HOSPITAL
Other names
Mad River Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARY RUTAN HOSPITAL
Authorized official
RON CARMIN (VP/FINANCE)
(937) 592-4015
Entity
Organization
Contact information
Practice address
4879 US HIGHWAY 68 S, WEST LIBERTY, OH 43357-9525
(937) 599-1411
(937) 465-9945
Mailing address
4879 US HIGHWAY 68 S, WEST LIBERTY, OH 43357-9525
(937) 599-1411
(937) 465-9945
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2055332
—
OH
Enumeration date
03/20/2006
Last updated
07/10/2007
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