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General NPI Number Information
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NPI Number | 1730544511
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Entity Type | Organization
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Legal Business Name | PROMEDICA CENTRAL PHYSICIANS LLC
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 5700 MONROE ST
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City | SYLVANIA
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State | OH
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Zip | 43560-2767
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Country | US
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Telephone | 578-585-0005
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Fax | 578-585-0004
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Provider Business Mailing Address
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Address Line | 5700 MONROE ST
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City | SYLVANIA
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State | OH
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Zip | 43560-2767
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Country | US
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Telephone | 578-585-0005
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Fax | 578-585-0004
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Authorized Official
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Title or Position | SUPERVISOR
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Name | AMY DWYER
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Credential |
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Telephone | 567-585-1934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | OH
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