Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 1 Spartan Way, Lima, Ohio |
Authorized Official Name and Position | Janis L. Sunderhaus (CEO) |
Authorized Official Contact | 4192213072 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
329 N West St Lima OH 45801-4332 Ph: (419) 221-3072 | 1 Spartan Way Lima OH 45801-4561 Ph: (419) 221-3072 |
NPI Number | 1740694462 |
---|---|
Provider Enumeration Date | 06/20/2014 |
Last Update Date | 02/02/2024 |
Medicare PECOS PAC ID | 9436139987 |
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Medicare Enrollment ID | O20140828001932 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740694462 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Physicians Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 750 W High St, Suite 250, Lima, OH 45807 Phone: 419-227-7399 Fax: 419-229-0123 | |
In House Internists, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 750 W High St, Suite 200, Lima, OH 45801 Phone: 419-229-2622 | |
Mercy Health Physicians Lima Specialty Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 770 W High St Ste 450, Lima, OH 45801 Phone: 419-996-5078 | |