MEDICARE: EAST TOLEDO FAMILY CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023867512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST TOLEDO FAMILY CENTER

Provider Business Mailing Address
First Line	:	1001 WHITE ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43605-3031
Country	:	US
Telephone Number	:	419-691-2254
Fax Number	:	419-691-2282

Provider Business Practice Location Address
First Line	:	1001 WHITE ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43605-3031
Country	:	US
Telephone Number	:	419-691-2254
Fax Number	:	419-691-2282

Authorized Official
Title or Position	:	DIRECTOR
Name	:	BRENDA HOLDREN
Credential	:
Telephone Number	:	419-691-2254

Provider Enumeration Date	:	05/16/2024
Last Update Date	:	10/08/2025

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Directions to “EAST TOLEDO FAMILY CENTER ” Practice Location

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