NPIMap

Organization Active NPI

Galion Community Hospital

  • Rural Health Clinic/Center
  • Crestline, OH
National Provider Identifier
1689806887
Registry record updated Mar 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GALION COMMUNITY HOSPITAL
Practice address
385 N. Seltzer Street
Crestline, OH 44827
Phone
(419) 468-4841
Fax
(419) 468-2381
NPI assigned
Aug 20, 2009
Organization subpart
Yes
Parent organization
GALION COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 29, 2014

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

385 N. Seltzer Street
Crestline, OH 44827

Mailing address

269 Portlandway South
Galion, OH 44833-2312
Phone (419) 468-4841

Other names 1

  • GCH Physician Practices, Seltzer Station Campus Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090803000325 OH Part A Provider - Rural Health Clinic 5496737439 Practice locations: Crestline, OH

Rural health clinic certification: CCN 363986

Legal name
GALION COMMUNITY HOSPITAL
Doing business as
GCH PHYSICIAN PRACTICES, SELTZER STATION CAMPUS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 25, 2010
Last certification
Dec 22, 2015
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Nov 5, 1954 in OH
Enrollment address
385N Seltzer St
Crestline, OH 44827-1400
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
GCH Medical Practice27 organizations share this tax ID, including this one
Part of
GCH Medical Practice

Other organizations with this tax ID 26

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

View all 26

Ownership & related parties

All disclosed owners & managing parties 18

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 Aug 1, 2009
Jeffrey Underwood Individual Corporate DirectorBoard Member Jan 1, 2014
Mark Schneider Individual Corporate DirectorBoard Member Aug 1, 2009
Linda Chambers Individual Corporate DirectorBoard Member Aug 1, 2009
Kymberly Fox Individual Corporate DirectorBoard Member Aug 1, 2009
Kay E McDonald Individual Corporate DirectorBoard Member Nov 17, 2014
Rex Cramer Individual Corporate DirectorBoard Member Aug 1, 2009
Charles Walker Individual Corporate DirectorBoard Member Aug 1, 2009
Jerome B Morasko Individual Contracted Managing EmployeeCeo Apr 13, 2009
Corporate OfficerCeo Apr 13, 2009
W-2 Managing EmployeeCeo Aug 1, 2009
Eric Geyer Individual Corporate DirectorBoard Member Aug 1, 2009
Philip M Brown Individual Corporate DirectorBoard Member Nov 17, 2014
John a Basinger Individual Corporate DirectorBoard Member Nov 17, 2014
Joseph Shadeed Individual Corporate DirectorBoard Member Nov 17, 2014
Donald E Draime Individual Corporate OfficerCfo Mar 29, 2010
Sherri L Clevenger Individual Corporate DirectorBoard Member Nov 17, 2014
Douglas Schilling Individual Corporate DirectorBoard Member Aug 1, 2009
Jason R McMullen Individual Corporate DirectorBoard Member Nov 17, 2014
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": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396051200000",
    "number": "1689806887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 PORTLANDWAY SOUTH",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448332312",
            "telephone_number": "419-468-4841",
            "fax_number": "419-468-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 N. SELTZER STREET",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "44827",
            "telephone_number": "419-468-4841",
            "fax_number": "419-468-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALION COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GALION COMMUNITY HOSPITAL",
        "enumeration_date": "2009-08-20",
        "last_updated": "2014-03-29",
        "status": "A",
        "authorized_official_last_name": "DRAIME",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_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, Seltzer Station Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crestline, OH

Sources for this page

Verify at the official NPI Registry.