Healthcare Provider Details

I. General information

NPI: 1700945193
Provider Name (Legal Business Name): OHIO THERAPEUTIC HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3063 W ELM ST
LIMA OH
45805-2514
US

IV. Provider business mailing address

1470 RIVERVIEW DR
LIMA OH
45805-3918
US

V. Phone/Fax

Practice location:
  • Phone: 419-999-1105
  • Fax: 419-999-1677
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier000000026713
Identifier TypeOTHER
Identifier StateOH
Identifier IssuerANTHEM-PIQUA
# 2
Identifier000000026717
Identifier TypeOTHER
Identifier StateOH
Identifier IssuerANTHEM-LIMA
# 3
Identifier2721200
Identifier TypeMEDICAID
Identifier StateOH
Identifier Issuer
# 4
Identifier000000026766
Identifier TypeOTHER
Identifier StateOH
Identifier IssuerANTHEM-SIDNEY

VIII. Authorized Official

Name: LINDA M ASCHETTINO
Title or Position: VICE PRESIDENT
Credential:
Phone: 419-999-1105