Healthcare Provider Details

I. General information

NPI: 1700680915
Provider Name (Legal Business Name): OHMAN FAMILY LIVING MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7160 CHAGRIN RD
CHAGRIN FALLS OH
44023-1134
US

IV. Provider business mailing address

PO BOX 265
NEWBURY OH
44065-0265
US

V. Phone/Fax

Practice location:
  • Phone: 440-338-2320
  • Fax:
Mailing address:
  • Phone: 440-338-2320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KURT INGERSOLL
Title or Position: VP OF OPERATIONS
Credential:
Phone: 440-338-2320