Healthcare Provider Details

I. General information

NPI: 1902497449
Provider Name (Legal Business Name): HEALTH PARTNERS OF WESTERN OHIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2021
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1018 RALSTON AVE
DEFIANCE OH
43512-5312
US

IV. Provider business mailing address

329 N WEST ST
LIMA OH
45801-4332
US

V. Phone/Fax

Practice location:
  • Phone: 419-567-2138
  • Fax: 419-225-8878
Mailing address:
  • Phone: 419-221-3072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: JANIS SUNDERHAUS
Title or Position: CEO
Credential:
Phone: 419-221-3072