Healthcare Provider Details

I. General information

NPI: 1598181810
Provider Name (Legal Business Name): LIMA MEMORIAL JOINT OPERATING COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2014
Last Update Date: 03/11/2014
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: 419-221-6142
  • Fax: 419-221-6152
Mailing address:
  • Phone: 419-221-6142
  • Fax: 419-221-6152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number022386550
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number1336144731
License Number StateOH

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MR. MIKE SWICK
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 419-221-5122