Community Memorial Hospital

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

34009629 Issued in OH

Legal business name

COMMUNITY MEMORIAL HOSPITAL

Doing business as

Hicksville Family Health Center

Practice address

208 Columbus St
Hicksville, OH 43526-1250

Phone

(419) 542-6692

NPI assigned

Jun 14, 2018

Organization subpart

Yes

Parent organization

COMMUNITY MEMORIAL HOSPITALAs reported in NPPES

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

Authorized official

Name

Janey Zachrich

Title

Ceo

Phone

(419) 542-5566

Specialties & licenses 1

Addresses

Other names 1

• Hicksville Family Health Center Doing business as

Part of

Community Memorial Hospital

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571788800000",
    "number": "1164915021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 COLUMBUS ST",
            "city": "HICKSVILLE",
            "state": "OH",
            "postal_code": "435261250",
            "telephone_number": "419-542-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 COLUMBUS ST",
            "city": "HICKSVILLE",
            "state": "OH",
            "postal_code": "435261250",
            "telephone_number": "419-542-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY MEMORIAL HOSPITAL",
        "enumeration_date": "2018-06-14",
        "last_updated": "2019-10-23",
        "status": "A",
        "authorized_official_last_name": "ZACHRICH",
        "authorized_official_first_name": "JANEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-542-5566"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "OH",
            "license": "34009629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hicksville Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michele Yvonne Biller
• Michael Stewart Boggs, DDS
• Brent a Roth DC Inc
• Chelsea Kelly DDS LLC
• Community Memorial Hospital (Community Memorial Hospital-SW)
• Community Memorial Hospital
• Katlyn Nicole Craig
• Dekalb Memorial Hospital, Inc (DeKalb Health Medical Group)
• Fort Wayne Cardiology Corporation
• Matt Walter Grant

• Rural Health Clinic/Center in Hicksville, OH
• Providers in Hicksville, OH by specialty
• Rural Health Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.