1407833759 NPI number — TOLEDO IMAGING, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407833759 NPI number — TOLEDO IMAGING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOLEDO IMAGING, 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:
6
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:
1407833759
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 76626
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44101-6500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-675-2498
Provider Business Mailing Address Fax Number:
813-971-0818

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5660 MONROE ST
Provider Second Line Business Practice Location Address:
SUITE 7
Provider Business Practice Location Address City Name:
SYLVANIA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43560-2733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-882-3333
Provider Business Practice Location Address Fax Number:
419-885-1568
Provider Enumeration Date:
12/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
WRIGHT
Authorized Official First Name:
GARY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
813-675-2600

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X , with the licence number:  0844IC , 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: 2297321 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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