MEDICARE: NORTHWEST OHIO ORTHOPEDICS AND SPORTS MEDICINE 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	332B00000X	Durable Medical Equipment & Medical Supplies	32-900011	OH

General Provider Information

NPI Number	:	1235582305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST OHIO ORTHOPEDICS AND SPORTS MEDICINE INC

Provider Business Mailing Address
First Line	:	7595 COUNTY ROAD 236
Second Line	:
City	:	FINDLAY
State	:	OH
Zip	:	45840-8738
Country	:	US
Telephone Number	:	419-427-1984
Fax Number	:	419-427-2864

Provider Business Practice Location Address
First Line	:	15054 STATE ROUTE 224 E
Second Line	:
City	:	FINDLAY
State	:	OH
Zip	:	45840-9794
Country	:	US
Telephone Number	:	419-427-3030
Fax Number	:	419-427-3034

Authorized Official
Title or Position	:	CFO
Name	:	MATT BOEHM
Credential	:
Telephone Number	:	419-427-3101

Provider Enumeration Date	:	07/13/2016
Last Update Date	:	11/08/2019

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