NPIMap

Organization Active NPI

Galion Community Hospital

Doing business as Avita Crestline Pharmacy

  • Pharmacy
  • Crestline, OH
National Provider Identifier
1346061256
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
GALION COMMUNITY HOSPITAL
Doing business as
Avita Crestline Pharmacy
Practice address
245 N Seltzer St
Crestline, OH 44827-1423
Phone
(419) 462-3806
Fax
(419) 462-3807
NPI assigned
Oct 23, 2024
Last updated
Sep 14, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
GALION COMMUNITY HOSPITAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Authorized official

Name
Alex Reed
Title
Cio
Phone
(419) 468-0602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

245 N Seltzer St
Crestline, OH 44827-1423

Mailing address

245 N Seltzer St
Crestline, OH 44827-1423
Phone (419) 462-3806

Other names 1

  • Avita Crestline Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241217001360 OH Part B Supplier - Mass Immunization (Roster Biller Only) 5496737439 Practice locations: Crestline, OH

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

245 N Seltzer St
Crestline, OH 44827

385 N Seltzer St
Unit 3
Crestline, OH 44827
Phone (419) 468-0449

385 N Seltzer St
Unit 4
Crestline, OH 44827
Phone (419) 462-3806

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

600 Richland Mall
Ontario, OH 44906
Phone (419) 462-4656

715 Richland Mall
Ste J
Ontario, OH 44906
Phone (567) 307-7570

Ownership & related parties

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.

Practitioners & affiliated clinicians

Practitioners 74

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789344000000",
    "number": "1346061256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 N SELTZER ST",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "448271423",
            "telephone_number": "419-462-3806",
            "fax_number": "419-462-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N SELTZER ST",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "448271423",
            "telephone_number": "419-462-3806",
            "fax_number": "419-462-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALION COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GALION COMMUNITY HOSPITAL, INC",
        "enumeration_date": "2024-10-23",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "CIO",
        "authorized_official_telephone_number": "419-468-0602"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avita Crestline Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crestline, OH

Sources for this page

Verify at the official NPI Registry.