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NPI Code Detail

MEDICARE: TLC NORTHWEST OHIO LLC

MEDICARE: TLC NORTHWEST OHIO LLC
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
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1619182870
Entity Type Code : Organization
Provider Name (Legal Business Name) : TLC NORTHWEST OHIO LLC
Provider Business Mailing Address
First Line : 16305 SWINGLEY RIDGE RD
Second Line : STE. 300
City : CHESTERFIELD
State : MO
Zip : 63017-1777
Country : US
Telephone Number : 636-534-2300
Fax Number :
Provider Business Practice Location Address
First Line : 3000 REGENCY CT
Second Line : STE. 100
City : TOLEDO
State : OH
Zip : 43623-3092
Country : US
Telephone Number : 419-882-2020
Fax Number :
Authorized Official
Title or Position : SECRETARY
Name : BRIAN L ANDREW
Credential :
Telephone Number : 636-534-2300
Provider Enumeration Date : 05/11/2007
Last Update Date : 08/22/2020

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Directions to “TLC NORTHWEST OHIO LLC ” Practice Location

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