Healthcare Provider Details

I. General information

NPI: 1033118526
Provider Name (Legal Business Name): LIMA EMERGENCY PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 W MARKET ST
LIMA OH
45801-4602
US

IV. Provider business mailing address

4750 HEMPSTEAD STATION DR
KETTERING OH
45429-5164
US

V. Phone/Fax

Practice location:
  • Phone: 419-227-3361
  • Fax: 419-226-9826
Mailing address:
  • Phone: 800-875-0136
  • Fax: 937-619-4150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number1402093
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier203400
Identifier TypeOTHER
Identifier StateOH
Identifier IssuerEEOICP GRP PROVIDER #
# 2
Identifier020408300
Identifier TypeOTHER
Identifier StateOH
Identifier IssuerFEDERAL BLACK LUNG GRP #
# 3
Identifier2027739014
Identifier TypeOTHER
Identifier StateOH
Identifier IssuerDEPARTMENT OF LABOR GRP #
# 4
Identifier2459325
Identifier TypeMEDICAID
Identifier StateOH
Identifier Issuer
# 5
Identifier000000317825
Identifier TypeOTHER
Identifier StateOH
Identifier IssuerBC/BS GRP PROVIDER NUMBER
# 6
IdentifierC37096
Identifier TypeOTHER
Identifier StateOH
Identifier IssuerHUMANA GRP PROVIDER #

VIII. Authorized Official

Name: DR. WILLIAM A COLE JR.
Title or Position: CEO
Credential: MD
Phone: 800-726-3627