| Vitae Health Medical Ohio Llc | |
|
599 S Shawnee St Lima OH 45804-1461 | |
| (419) 227-2154 | |
| Not Available |
| Full Name | Vitae Health Medical Ohio Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 599 S Shawnee St, Lima, Ohio |
| Authorized Official Name and Position | Amish Patel (PRESIDENT) |
| Authorized Official Contact | 2247778045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitae Health Medical Ohio Llc 415 W Golf Rd Ste 26 Arlington Heights IL 60005-3923 Ph: (224) 777-8045 | Vitae Health Medical Ohio Llc 599 S Shawnee St Lima OH 45804-1461 Ph: (419) 227-2154 |
| NPI Number | 1093421208 |
|---|---|
| Provider Enumeration Date | 01/31/2023 |
| Last Update Date | 06/14/2023 |
| Certification Date | 06/14/2023 |
| Medicare PECOS PAC ID | 4688030554 |
|---|---|
| Medicare Enrollment ID | O20230518002116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093421208 | NPI | - | NPPES |
| Provider Name | Colby Meuleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629732102 PECOS PAC ID: 1254726482 Enrollment ID: I20220324001610 |
| Provider Name | Ellie Beth Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093463275 PECOS PAC ID: 2668859653 Enrollment ID: I20220512001709 |
| Provider Name | Paulette Hennon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992402820 PECOS PAC ID: 3173996386 Enrollment ID: I20230308001135 |
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