1669550182 NPI number — FAMILY PHYSICIANS OF LIMA 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 1669550182 NPI number — FAMILY PHYSICIANS OF LIMA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY PHYSICIANS OF LIMA 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:
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:
1669550182
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2875 W ELM ST
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
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-991-7805
Provider Business Mailing Address Fax Number:
419-991-7862

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
119 S BROADWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPENCERVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45887
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-647-4165
Provider Business Practice Location Address Fax Number:
419-647-4183
Provider Enumeration Date:
11/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KRENDL
Authorized Official First Name:
KARRI
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
419-991-7805

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , 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: 1710972047 . This is a "NPI ERIC T STALLKAMP MD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0823854 . This is a "MEDICAID, GROUP #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1184619595 . This is a "NPI ELISE D CLARK CNP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 9934001 . This is a "MEDICARE, GROUP #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1134112469 . This is a "GROUP NPI#, PRIMARY OFFIC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1346235728 . This is a "NPI CHRISTINE R GAYNIER M" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1215941711 . This is a "NPI TRACY L SHARP DO" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1831183896 . This is a "NPI KARRI L KRENDL MD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com