1619143237 NPI number — LATOSH CONSULTING SERVICES INC

Table of content: (NPI 1619143237)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619143237 NPI number — LATOSH CONSULTING SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LATOSH CONSULTING SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619143237
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1614 S BYRNE RD
Provider Second Line Business Mailing Address:
SUITE AA
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43614-3464
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-382-1933
Provider Business Mailing Address Fax Number:
419-382-1933

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1614 S BYRNE RD
Provider Second Line Business Practice Location Address:
SUITE AA
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43614-3464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-382-1933
Provider Business Practice Location Address Fax Number:
419-382-1933
Provider Enumeration Date:
05/03/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
OSINOWO
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
OLAIDE
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
419-699-8294

Provider Taxonomy Codes

  • Taxonomy code: 103TP0016X , with the licence number:  35-082528 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)