Healthcare Provider Details

I. General information

NPI: 1245235142
Provider Name (Legal Business Name): LIMA MEMORIAL JOINT OPERATING COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 BELLEFONTAINE AVE
LIMA OH
45804-2800
US

IV. Provider business mailing address

1001 BELLEFONTAINE AVE
LIMA OH
45804-2800
US

V. Phone/Fax

Practice location:
  • Phone: 419-226-5165
  • Fax: 419-226-5128
Mailing address:
  • Phone: 419-226-5165
  • Fax: 419-226-5128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateOH

VIII. Authorized Official

Name: MR. JOHN T FISCHBACH
Title or Position: CFO
Credential:
Phone: 419-226-5163