Provider Demographics
NPI:1174671796
Name:PORTAGE COUNTY COMBINED GENERAL HEALTH DISTRICT
Entity type:Organization
Organization Name:PORTAGE COUNTY COMBINED GENERAL HEALTH DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DIORIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-296-9919
Mailing Address - Street 1:999 E. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3325
Mailing Address - Country:US
Mailing Address - Phone:330-296-9919
Mailing Address - Fax:330-298-4492
Practice Address - Street 1:999 E. MAIN STREET
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3325
Practice Address - Country:US
Practice Address - Phone:330-296-9919
Practice Address - Fax:330-298-4492
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PORTAGE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-08
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0438753Medicaid