Healthcare Provider Details

I. General information

NPI: 1942047519
Provider Name (Legal Business Name): RE-CIRCUIT ELECTRONICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 S HOLLAND SYLVANIA RD STE 3
TOLEDO OH
43615-6382
US

IV. Provider business mailing address

855 S HOLLAND SYLVANIA RD STE 3
TOLEDO OH
43615-6382
US

V. Phone/Fax

Practice location:
  • Phone: 419-973-3942
  • Fax:
Mailing address:
  • Phone: 419-973-3942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. BENJAMIN WESLEY TOURNOY
Title or Position: D00
Credential:
Phone: 419-973-3942