Provider Demographics
NPI:1487048278
Name:MCCULLOUGH-HYDE HOSPITAL
Entity type:Organization
Organization Name:MCCULLOUGH-HYDE HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CRISTELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS
Authorized Official - Phone:513-664-3801
Mailing Address - Street 1:5151 MORNING SUN RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-9545
Mailing Address - Country:US
Mailing Address - Phone:513-664-3801
Mailing Address - Fax:
Practice Address - Street 1:5151 MORNING SUN RD
Practice Address - Street 2:SUITE E
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-9545
Practice Address - Country:US
Practice Address - Phone:513-664-3801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7317282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital