| Dr. Wilfred Ellis Building | |
|
329 N West St Lima OH 45801 | |
| (419) 221-3072 | |
| (419) 225-8878 |
| Full Name | Dr. Wilfred Ellis Building |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 329 N West St, Lima, Ohio |
| Authorized Official Name and Position | Janis L Sunderhaus (CEO) |
| Authorized Official Contact | 4192213072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Wilfred Ellis Building 329 N West St Lima OH 45801-4332 Ph: (419) 221-3072 | Dr. Wilfred Ellis Building 329 N West St Lima OH 45801 Ph: (419) 221-3072 |
| NPI Number | 1255820858 |
|---|---|
| Provider Enumeration Date | 05/09/2018 |
| Last Update Date | 07/05/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255820858 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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