1356339857 NPI number — TOLEDO PAIN SERVICES, PLL

Table of content: (NPI 1356339857)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356339857 NPI number — TOLEDO PAIN SERVICES, PLL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOLEDO PAIN SERVICES, PLL
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:
COMPREHENSIVE CENTERS FOR PAIN MANAGEMENT
Provider Other Organization Name Type Code:
3
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:
1356339857
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3400 MEIJER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43617-1166
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-843-1370
Provider Business Mailing Address Fax Number:
419-843-1362

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3400 MEIJER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43617-1166
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-843-1370
Provider Business Practice Location Address Fax Number:
419-843-1362
Provider Enumeration Date:
10/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
JAMES
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
G
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
419-843-1370

Provider Taxonomy Codes

  • Taxonomy code: 208VP0014X , with the licence number:  35051358 , 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)

  • Identifier: 0954712 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1356339857 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1497953749 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1699750364 . This is a "NPI JEAN PEYTON" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1306199641 . This is a "MORROW" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2429241 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2612793 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0703073 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1831110048 . This is a "FRAME" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2495698 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2940509 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1487734992 . This is a "HALLETT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1861481640 . This is a "NPI -JAMES WEISS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2595446 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1346496304 . This is a "NPI" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2741206 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: H125931 . This is a "T HALLETT PTAN-MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1811089147 . This is a "SZYMANSKI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1083834774 . This is a "NPI-CURRAN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1811227077 . This is a "CCHESSER" identifier . This identifiers is of the category "OTHER".




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