Healthcare Provider Details

I. General information

NPI: 1447709076
Provider Name (Legal Business Name): GASTRO-INTESTINAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2016
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W NORTH AVE
ADA OH
45810-1041
US

IV. Provider business mailing address

2793 SHAWNEE RD
LIMA OH
45806-1444
US

V. Phone/Fax

Practice location:
  • Phone: 419-227-8209
  • Fax: 419-227-8224
Mailing address:
  • Phone: 419-227-8209
  • Fax: 419-227-8224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. PATRICIA M SCHNIPKE
Title or Position: OFFICE MANAGER
Credential:
Phone: 419-227-8209