Healthcare Provider Details

I. General information

NPI: 1922054634
Provider Name (Legal Business Name): MEDICAL UNIVERSITY OF OHIO AT TOLEDO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 03/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ARLINGTON AVE # MS 1076
TOLEDO OH
43614-2595
US

IV. Provider business mailing address

3000 ARLINGTON AVE # MS 1076
TOLEDO OH
43614-2595
US

V. Phone/Fax

Practice location:
  • Phone: 419-383-3706
  • Fax: 419-383-3208
Mailing address:
  • Phone: 419-383-3706
  • Fax: 419-383-3208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number021453400
License Number StateOH

VIII. Authorized Official

Name: MR. DAVE MORLOCK
Title or Position: CHIEF EXECUTIVE OFFICE
Credential:
Phone: 419-383-6668