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Galion Community Hospital

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

NPI 1215285259 · NPPES record last updated Apr 7, 2014

Key facts

NPI
1215285259
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
GALION COMMUNITY HOSPITAL
Practice address
1323 E Mansfield St
Bucyrus, OH 44820-1960
Phone
(419) 563-0300
NPI assigned
Aug 23, 2012
Organization subpart
Yes
Parent organization (as reported)
GALION COMMUNITY HOSPITAL

Authorized official

Name
Donald Eric Draime
Title
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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Rural health clinic certification: CCN 363991

Legal name
GALION COMMUNITY HOSPITAL
Doing business as
GCH PHYSICIAN PRACTICE-MAPLE CREEK MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 16, 2013
Last certification
Sep 16, 2013
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
Nov 5, 1954 in OH
Enrollment address
1323 East Mansfield Street
Bucyrus, OH 44820-1960
Related CCNs
361325

All disclosed owners & managing parties 7

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 Dec 31, 2007
Jerome B Morasko
Individual 		Corporate Officer
Ceo		 Apr 13, 2009
Philip M Brown
Individual 		Corporate Director
Board Member		 Jan 28, 2010
Donald E Draime
Individual 		Corporate Officer
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
O20121116000468 OH Part a Provider - Rural Health Clinic 5496737439 Practice locations: Bucyrus, OH

National Provider Directory

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

Locations

1323 E Mansfield St
Bucyrus, OH 44820
Phone (419) 462-4588

Specialties & licenses

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

Addresses

Primary practice location

1323 E Mansfield St
Bucyrus, OH 44820-1960

Mailing address

269 Portland Way S
Galion, OH 44833-2312
Phone (419) 468-4841

Other names

  • GCH Physician Practice Maple Creek Medical Clinic Doing business as

Other providers in Bucyrus, OH

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

Sources for this page

Verify at the official NPI Registry.