Organization
CIVISTA MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT ZANGER (CHIEF FINANCIAL OFFICER)
(301) 609-5163
Entity
Organization
Contact information
Practice address
5 GARRETT AVENUE, LA PLATA, MD 20646-1070
(301) 609-4474
(301) 609-4411
Mailing address
PO BOX 1070, LA PLATA, MD 20646-1070
(301) 609-5163
(301) 934-0053
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003355200
—
MD
Enumeration date
06/24/2005
Last updated
09/11/2023
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