MEDICARE: JOANN M GOTTSCHLING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	302R00000X	Health Maintenance Organization	70050983	OH

General Provider Information

NPI Number	:	1235370297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOANN M GOTTSCHLING

Provider Business Mailing Address
First Line	:	605 S TRIMBLE RD
Second Line	:	STE. A
City	:	MANSFIELD
State	:	OH
Zip	:	44906-4112
Country	:	US
Telephone Number	:	419-756-0766
Fax Number	:	419-756-0701

Provider Business Practice Location Address
First Line	:	605 S TRIMBLE RD
Second Line	:	STE. A
City	:	MANSFIELD
State	:	OH
Zip	:	44906-4112
Country	:	US
Telephone Number	:	419-756-0766
Fax Number	:	419-756-0701

Authorized Official
Title or Position	:	SUPPLIER/FITTER
Name	:	MRS. JOANN M GOTTSCHLING
Credential	:	DME/FITTER
Telephone Number	:	419-756-0766

Provider Enumeration Date	:	03/20/2009
Last Update Date	:	03/24/2011

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