Healthcare Provider Details

I. General information

NPI: 1215475199
Provider Name (Legal Business Name): OHIO POST-ACUTE MEDICAL SERVICES 1 INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2017
Last Update Date: 03/08/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 LAURICELLA CT
ENGLEWOOD OH
45322
US

IV. Provider business mailing address

307 S EVERGREEN AVE
WOODBURY NJ
08096-2739
US

V. Phone/Fax

Practice location:
  • Phone: 937-836-5143
  • Fax:
Mailing address:
  • Phone: 856-686-4316
  • Fax: 865-291-3254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM COLE
Title or Position: PRESIDENT
Credential: MD
Phone: 856-686-4316