MEDICARE: LIMA EMERGENCY PHYSICIANS INC

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	207P00000X	Emergency Medicine Physician	1402093	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	203400	OTHER	OH	EEOICP GRP PROVIDER #
2	020408300	OTHER	OH	FEDERAL BLACK LUNG GRP #
3	2027739014	OTHER	OH	DEPARTMENT OF LABOR GRP #
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	000000317825	OTHER	OH	BC/BS GRP PROVIDER NUMBER
6	C37096	OTHER	OH	HUMANA GRP PROVIDER #

General Provider Information

NPI Number	:	1033118526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIMA EMERGENCY PHYSICIANS INC

Provider Business Mailing Address
First Line	:	4750 HEMPSTEAD STATION DR
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45429-5164
Country	:	US
Telephone Number	:	800-875-0136
Fax Number	:	937-619-4150

Provider Business Practice Location Address
First Line	:	730 W MARKET ST
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-4602
Country	:	US
Telephone Number	:	419-227-3361
Fax Number	:	419-226-9826

Authorized Official
Title or Position	:	CEO
Name	:	DR. WILLIAM A COLE JR.
Credential	:	MD
Telephone Number	:	800-726-3627

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	09/16/2011

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