Healthcare Provider Details
I. General information
NPI: 1992117246
Provider Name (Legal Business Name): THE TOLEDO HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2014
Last Update Date: 07/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5855 MONROE ST
SYLVANIA OH
43560-2269
US
IV. Provider business mailing address
5855 MONROE ST
SYLVANIA OH
43560-2269
US
V. Phone/Fax
- Phone: 419-824-7334
- Fax: 419-824-7359
- Phone: 419-824-7334
- Fax: 419-824-7359
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | |
| License Number State | OH |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | OH |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | |
| License Number State | OH |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | OH |
VIII. Authorized Official
Name:
AMY
L
DWYER
Title or Position: CREDENTIALING SUPERVISOR
Credential:
Phone: 419-824-7334