MEDICARE: VAN WERT MEDICAL SERVICES, LTD.

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	35048258	OH
2	207R00000X	Internal Medicine Physician	35-06-3622	OH
3	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	35058390	OH
4	207VG0400X	Gynecology Physician	35128002	OH
5	207VX0000X	Obstetrics Physician	35121140	OH
6	2080A0000X	Pediatric Adolescent Medicine Physician	35086105	OH
7	208100000X	Physical Medicine & Rehabilitation Physician		OH
8	208600000X	Surgery Physician	35071740	OH
9	208M00000X	Hospitalist Physician	35063622	OH
10	208M00000X	Hospitalist Physician	35089010	OH
11	213ES0103X	Foot & Ankle Surgery Podiatrist	36003593	OH
12	213ES0103X	Foot & Ankle Surgery Podiatrist	36002056	OH
13	363L00000X	Nurse Practitioner	NP07379	OH
14	363LF0000X	Family Nurse Practitioner	NP08410	OH
15	207Q00000X	Family Medicine Physician	35-07-8450-M	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942268735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VAN WERT MEDICAL SERVICES, LTD.

Provider Business Mailing Address
First Line	:	1250 S WASHINGTON ST
Second Line	:
City	:	VAN WERT
State	:	OH
Zip	:	45891-2551
Country	:	US
Telephone Number	:	419-238-6735
Fax Number	:	419-232-5271

Provider Business Practice Location Address
First Line	:	140 FOX RD
Second Line	:	STE 201
City	:	VAN WERT
State	:	OH
Zip	:	45891-2475
Country	:	US
Telephone Number	:	419-238-6735
Fax Number	:	419-232-5271

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. MICHAEL HOLLIDAY
Credential	:
Telephone Number	:	419-238-8285

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	05/01/2017

Similar Medicare Providers

1225032964 — DR. MATTHEW W. MILLER M.D.
Practice Location Address:

140 FOX RD , SUITE 202
VAN WERT, OH
45891-2475

Practice Phone: 419-238-6735
Practice Fax: 419-232-5271

1487611802 — HOME MEDICAL EQUIPMENT SOLUTIONS
Practice Location Address:

140 FOX RD , SUITE 208
VAN WERT, OH
45891-2475

Practice Phone: 419-238-9825
Practice Fax: 419-238-9343

1558329516 — DR. THOMAS EDWARD CONTE MD
Practice Location Address:

140 FOX RD , SUITE 401
VAN WERT, OH
45891-2475

Practice Phone: 419-238-4909
Practice Fax: 419-238-9615

1750395067 — LYONS ANESTHESIA, INC.
Practice Location Address:

140 FOX RD , SUITE 207
VAN WERT, OH
45891-2475

Practice Phone: 419-232-2866
Practice Fax: 419-232-2867

1871507178 — HOCKENBERRY ANESTHESIA, INC.
Practice Location Address:

140 FOX RD , SUITE 207
VAN WERT, OH
45891-2475

Practice Phone: 419-232-2866
Practice Fax: 419-232-2867

1538173844 — VW ANESTHESIA, INC.
Practice Location Address:

140 FOX RD , SUITE 207
VAN WERT, OH
45891-2475

Practice Phone: 419-232-2866
Practice Fax: 419-232-2867

Directions to “VAN WERT MEDICAL SERVICES, LTD. ” Practice Location

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