MEDICARE: PROMEDICA CENTRAL PHYSICIANS

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1396603148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROMEDICA CENTRAL PHYSICIANS

Provider Business Mailing Address
First Line	:	100 MADISON AVE FL 3
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43604-1516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 OWENS CORNING PKWY # B-2
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43659-1000
Country	:	US
Telephone Number	:	567-585-0060
Fax Number	:	567-455-5902

Authorized Official
Title or Position	:	DIRECTOR, SYSTEM CREDENTIALING
Name	:	TANYA WINES
Credential	:
Telephone Number	:	567-585-0422

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

Similar Medicare Providers

1629405089 — MRS. SHELLY LYNN TURSKI RN MSN NP-C
Practice Location Address:

1 OWENS CORNING PKWY
TOLEDO, OH
43659-1177

Practice Phone: 675-850-0605
Practice Fax: 567-455-5902

1023053659 — DR. BENEDICT R. HAEG M.D.
Practice Location Address:

425 ELM ST N , CENTRACARE HEALTH SYSTEM-SAUK CENTRE
SAUK CENTRE, MN
56303-1010

Practice Phone: 320-352-6591
Practice Fax: 320-352-5164

1871596775 — PROHAB REHABILITATION SERVICES, INC.
Practice Location Address:

1000 REGENCY CT , STE 105
TOLEDO, OH
43623-3074

Practice Phone: 419-885-2322
Practice Fax:

1659376978 — DINO J COSTA O.D.
Practice Location Address:

1000 REGENCY CT , STE 100
TOLEDO, OH
43623-3074

Practice Phone: 419-882-0588
Practice Fax: 419-885-3070

1407851736 — KHALIL A RAFFOUL M.D.
Practice Location Address:

1000 REGENCY CT , STE 100
TOLEDO, OH
43623-3074

Practice Phone: 419-882-0588
Practice Fax: 419-885-3070

1093710337 — CAROL J GERMAN O.D.
Practice Location Address:

1000 REGENCY CT , STE 100
TOLEDO, OH
43623-3074

Practice Phone: 419-882-0588
Practice Fax: 419-885-3070

Directions to “PROMEDICA CENTRAL PHYSICIANS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.