1740213677 NPI number — DIALYSIS PARTNERS OF NORTHWEST OHIO, LLC

Table of content: JOANNA J. LAMBERT M.ED. (NPI 1164734505)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740213677 NPI number — DIALYSIS PARTNERS OF NORTHWEST OHIO, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIALYSIS PARTNERS OF NORTHWEST OHIO, LLC
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:
DIALYSIS PARTNERS OF NORTHWEST OHIO
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:
1740213677
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30100 TELEGRAPH RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
BINGHAM FARMS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48025-4516
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-723-0224
Provider Business Mailing Address Fax Number:
248-642-7852

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3401 GLENDALE AVE
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43614-2418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-389-9681
Provider Business Practice Location Address Fax Number:
419-389-9196
Provider Enumeration Date:
07/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SHEPHERD
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
F
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
248-642-5038

Provider Taxonomy Codes

  • Taxonomy code: 261QE0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 707595 . This is a "FAMILY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 362509 . This is a "STERLING OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4520152 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2168701 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6800612 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 707595 . This is a "BUCKEYE COMM HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000327208 . This is a "ANTHEM BC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 03315 . This is a "PARAMOUNT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000327208 . This is a "BLUE CROSS OF MICHIGAN" identifier . This identifiers is of the category "OTHER".




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