1629092275 NPI number — HCF OF CELINA, 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 1629092275 NPI number — HCF OF CELINA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HCF OF CELINA, 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:
CELINA MANOR
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:
1629092275
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 SHAWNEE RD
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:
45805-3583
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-999-2010
Provider Business Mailing Address Fax Number:
419-999-6284

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 MYERS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CELINA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45822-1137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-586-6645
Provider Business Practice Location Address Fax Number:
419-586-5858
Provider Enumeration Date:
07/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
UNVERFERTH
Authorized Official First Name:
CHAD
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
VICE PRESIDENT - FINANCE & CFO
Authorized Official Telephone Number:
419-999-2010

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  1666N , 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: 000000317807 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2437303 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1003325 . This is a "OHIO HEALTH CHOICE INC." identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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