1154150167 NPI number — HEALTH PARTNERS OF WESTERN OHIO

Table of content: TRACI JO PARILLO FNP-C (NPI 1457968307)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154150167 NPI number — HEALTH PARTNERS OF WESTERN OHIO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH PARTNERS OF WESTERN OHIO
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:
1154150167
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
329 N WEST STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIMA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45801-4332
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-221-3072
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9105 HARDING HWY RM K129
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARROD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45850-9485
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-224-4250
Provider Business Practice Location Address Fax Number:
419-225-8878
Provider Enumeration Date:
07/29/2024

Additional Information

Authorized Official

Authorized Official Last Name:
SUNDERHAUS
Authorized Official First Name:
JANIS
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
419-221-3072

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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