Healthcare Provider Details

I. General information

NPI: 1912903014
Provider Name (Legal Business Name): LIMA MEMORIAL JOINT OPERATING COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 BELLEFONTAINE AVE
LIMA OH
45804-3109
US

IV. Provider business mailing address

1001 BELLEFONTAINE AVE
LIMA OH
45804-2800
US

V. Phone/Fax

Practice location:
  • Phone: 419-226-5020
  • Fax: 419-998-4510
Mailing address:
  • Phone: 419-226-5020
  • Fax: 419-998-4510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateOH

VII. Legacy identifiers

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

# 1
Identifier5349215
Identifier TypeOTHER
Identifier State
Identifier IssuerAETNA
# 2
Identifier05199V7
Identifier TypeOTHER
Identifier State
Identifier IssuerPARAMOUNT
# 3
Identifier000000293412
Identifier TypeOTHER
Identifier State
Identifier IssuerBLUE CROSS
# 4
Identifier0610137
Identifier TypeMEDICAID
Identifier StateOH
Identifier Issuer

VIII. Authorized Official

Name: TIMOTHY ALAN BUIT
Title or Position: CFO
Credential:
Phone: 419-226-5163