Organization
OTTERBEIN ST. MARYS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RITA C HAWKINS (AVP FINANCE/CONTROLLER)
(513) 933-5401
Entity
Organization
Contact information
Practice address
11230 STATE ROUTE 364, SAINT MARYS, OH 45885-9534
(419) 394-2366
(419) 394-2367
Mailing address
11230 STATE ROUTE 364, SAINT MARYS, OH 45885-9534
(419) 394-2366
(419) 394-2367
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1960
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0966012
—
OH
01
—
4488260001
DMERC
—
Enumeration date
08/22/2005
Last updated
01/05/2015
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