1841688728 NPI number — OHIO LIVING HOLDINGS

Table of content: JULIE CHRISTINE PAYNE M.D (NPI 1548315807)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841688728 NPI number — OHIO LIVING HOLDINGS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OHIO LIVING HOLDINGS
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:
1841688728
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/27/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25 INDIANA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONROE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45050-1146
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-681-8174
Provider Business Mailing Address Fax Number:
513-681-1850

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25 INDIANA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45050-1146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-681-8174
Provider Business Practice Location Address Fax Number:
513-681-1850
Provider Enumeration Date:
12/31/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GUMINA
Authorized Official First Name:
LAURENCE
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
614-888-7800

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  0157HSP , 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)