Healthcare Provider Details
I. General information
NPI: 1992393706
Provider Name (Legal Business Name): HEALTH PARTNERS OF WESTERN OHIO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/07/2021
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
441 E 8TH ST
LIMA OH
45804-2482
US
IV. Provider business mailing address
329 N WEST ST
LIMA OH
45801-4332
US
V. Phone/Fax
- Phone: 419-221-3072
- Fax:
- Phone: 419-221-3072
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JANIS
SUNDERHAUS
Title or Position: CEO
Credential:
Phone: 419-221-3072