Healthcare Provider Details

I. General information

NPI: 1497707475
Provider Name (Legal Business Name): BENCHMARK HEALTHCARE OF TOLEDO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 01/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4645 LEWIS AVE
TOLEDO OH
43612-2336
US

IV. Provider business mailing address

4645 LEWIS AVE
TOLEDO OH
43612-2336
US

V. Phone/Fax

Practice location:
  • Phone: 419-478-5131
  • Fax:
Mailing address:
  • Phone: 419-478-5131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1249N
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number1249N
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number1249N
License Number StateOH

VIII. Authorized Official

Name: SHARON L REYNOLDS
Title or Position: PRESIDENT
Credential:
Phone: 937-964-8974