Basic Information
Provider Information
NPI: 1083045504
EntityType: 2
ReplacementNPI:  
OrganizationName: ROBINSON HEALTH SYSTEM, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: ROBINSON MEMORIAL HOSPITAL
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 6847 N CHESTNUT ST
Address2:  
City: RAVENNA
State: OH
PostalCode: 442663929
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 6847 N CHESTNUT ST
Address2:  
City: RAVENNA
State: OH
PostalCode: 442663929
CountryCode: US
TelephoneNumber: 3302970811
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/10/2013
LastUpdateDate: 12/10/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: COLECCHI
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT AND CEO
AuthorizedOfficialTelephone: 3302972310
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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