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Organization Active NPI

Galion Community Hospital

Doing business as GCH Physician Practices, Bucyrus Road Campus

  • Rural Health Clinic/Center
  • Galion, OH
National Provider Identifier
1023322674
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GALION COMMUNITY HOSPITAL
Doing business as
GCH Physician Practices, Bucyrus Road Campus
Practice address
955 Bucyrus Rd
Galion, OH 44833-1509
Phone
(419) 468-4220
Fax
(419) 462-7019
NPI assigned
Aug 5, 2010
Last updated
Aug 5, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eric Draime
Title
Cfo
Phone
(419) 468-0501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

955 Bucyrus Rd
Galion, OH 44833-1509

Mailing address

955 Bucyrus Rd
Galion, OH 44833-1509
Phone (419) 468-4220

Other names 1

  • GCH Physician Practices, Bucyrus Road Campus Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100916000788 OH Part A Provider - Rural Health Clinic 5496737439 Practice locations: Galion, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023322674. Details of each certification follow.

Rural health clinic certification: CCN 363987

Legal name
GALION COMMUNITY HOSPITAL
Doing business as
GCH PHYSICIAN PRACTICES, BUCYRUS ROAD CAMPUS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 24, 2011
Last certification
Feb 21, 2017
Ownership / control type
1B
Organization structure
CorporationNon-profit
Incorporated
Nov 5, 1954 in OH
Enrollment address
955 Bucyrus Rd
Galion, OH 44833-1509
Related CCNs
361325

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

National Provider Directory

National Provider Directory
Tax ID family
James a Goudy II MD27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Locations

955 Bucyrus Rd
Galion, OH 44833
Phone (419) 468-4220

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Donald Barr Individual Corporate DirectorBoard Member Sep 1, 2010
Jeffrey Underwood Individual Corporate DirectorBoard Member Jan 1, 2014
Mark Schneider Individual Corporate DirectorBoard Member Sep 1, 2010
Linda Chambers Individual Corporate DirectorBoard Member Sep 1, 2010
Kymberly Fox Individual Corporate DirectorBoard Member Sep 1, 2010
Kay E McDonald Individual Corporate DirectorBoard Member Jan 28, 2010
Rex Cramer Individual Corporate DirectorBoard Member Sep 1, 2010
Charles Walker Individual Corporate DirectorBoard Member Sep 1, 2010
Jerome B Morasko Individual Contracted Managing EmployeeCeo Apr 13, 2009
Corporate OfficerCeo Apr 13, 2009
W-2 Managing EmployeeCeo Sep 1, 2010
Eric Geyer Individual Corporate DirectorBoard Member Sep 1, 2010
Philip M Brown Individual Corporate DirectorBoard Member Jan 28, 2011
Joseph Shadeed Individual Corporate DirectorBoard Member Jan 27, 2011
Donald E Draime Individual Corporate OfficerCfo Mar 29, 2010
Sherri L Clevenger Individual Corporate DirectorBoard Member Jan 1, 2010
Douglas Schilling Individual Corporate DirectorBoard Member Sep 1, 2010
Jason R McMullen Individual Corporate DirectorBoard Member Jan 27, 2011
Donald Plotts Individual Corporate DirectorBoard Member Jan 1, 2014

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bucyrus Community HospitalBucyrus, OH, CCN 361316 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 31, 2010
Avita OntarioOntario, OH, CCN 360365 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 8, 2015
GCH Physician Practice Gaius StreetBucyrus, OH, CCN 363411 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 5, 1954

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1023322674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 BUCYRUS RD",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448331509",
            "telephone_number": "419-468-4220",
            "fax_number": "419-462-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 BUCYRUS RD",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448331509",
            "telephone_number": "419-468-4220",
            "fax_number": "419-462-7019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALION COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-05",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "DRAIME",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "419-468-0501"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GCH Physician Practices, Bucyrus Road Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Galion, OH

Sources for this page

Verify at the official NPI Registry.