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Galion Community Hospital

Organization Active NPI Rural Health Clinic/Center · Ontario, OH

NPI 1194154294 · NPPES record last updated Mar 26, 2014

Key facts

NPI
1194154294
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
GALION COMMUNITY HOSPITAL
Practice address
2981 W 4TH St
Ontario, OH 44906-1267
Phone
(419) 462-4561
NPI assigned
Nov 8, 2013
Organization subpart
No

Authorized official

Name
Mr. Donald E Draime
Title
Vice President/Cfo
Phone
(419) 468-0501

Owned or controlled facilities with NPI records 3

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

Other NPIs with the same Medicare PAC ID 16

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

Corporate family (same tax ID) 26

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

View all 26

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

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 40

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2033336Ontario Physician Practices
2981 W Fourth St, Mansfield, OH 44906		Certificate of waiverNov 29, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Rural health clinic certification: CCN 363410

Legal name
GALION COMMUNITY HOSPITAL
Doing business as
ONTARIO PHYSICIAN PRACTICES
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 24, 2015
Last certification
May 24, 2015
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
Nov 5, 1954 in OH
Enrollment address
2981 W 4TH St
Ontario, OH 44906-1267
Related CCNs
361325

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Kay E McDonald
Individual 		Corporate Director
Board Member		 Jan 28, 2010
Michelle L Burgin
Individual 		W-2 Managing Employee
VP of Physician Services		 Dec 31, 2007
Jerome B Morasko
Individual 		Corporate Officer
President, Ceo		 Apr 13, 2009
Philip M Brown
Individual 		Corporate Director
Board Member		 Jan 28, 2010
John a Basinger
Individual 		Corporate Director
Board Member		 Jan 27, 2011
Joseph Shadeed
Individual 		Corporate Director
Board Member		 Jan 27, 2011
Donald E Draime
Individual 		Corporate Officer
VP, Cfo		 Mar 29, 2010
Sherri L Clevenger
Individual 		Corporate Director
Board Member		 Jan 28, 2010
Jason R McMullen
Individual 		Corporate Director
Board Member		 Jan 27, 2011

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

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140829001477 OH Part a Provider - Rural Health Clinic 5496737439 Practice locations: Ontario, OH

National Provider Directory

Tax ID family
GCH Medical Practice (27 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

2981 W 4TH St
Ontario, OH 44906-1267

Mailing address

2981 W 4TH St
Ontario, OH 44906-1267

Other names

  • Ontario Physician Practices Doing business as

Other providers in Ontario, OH

All providers in Ontario, OH · Rural Health Clinic/Center in Ohio

Sources for this page

Verify at the official NPI Registry.