PROMEDICA CENTRAL CORPORATION OF MICHIGAN NPI 1588624696

NPI Information

NPI: 1588624696
Provider Name: PROMEDICA CENTRAL CORPORATION OF MICHIGAN
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 36D2262429

Address:
100 MADISON AVE
MSC-S38805
TOLEDO, OH
ZIP 43604
Phone: (844) 373-0871
Get Directions

PROMEDICA CENTRAL CORPORATION OF MICHIGAN is a family medicine in Toledo, OH. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PROMEDICA CENTRAL CORPORATION OF MICHIGAN NPI is 1588624696. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

100 MADISON AVE
MSC-S38805
TOLEDO, OH
ZIP 43604
Phone: (844) 373-0871
Fax: (419) 885-3921

The provider's authorized official is Tanya Wines .
The authorized official title is Director, System Credentialing and has the following contact phone number (567) 585-0422.

The CLIA number assigned to this NPI record is 36D2262429 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/23/2006 and was last updated on 10/4/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	208000000X	Pediatrics			No
2	208600000X	Surgery		MICHIGAN	No
3	261QR1300X	Clinic/Center	Rural Health		No
4	207RC0000X	Internal Medicine	Cardiovascular Disease	MICHIGAN	No
5	207RE0101X	Internal Medicine	Endocrinology, Diabetes & Metabolism	MICHIGAN	No
6	207V00000X	Obstetrics & Gynecology			No
7	207X00000X	Orthopaedic Surgery		MICHIGAN	No
8	207R00000X	Internal Medicine			No
9	207Y00000X	Otolaryngology		MICHIGAN	No
10	207L00000X	Anesthesiology			No
11	207Q00000X	Family Medicine		MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	160D610660	OTHER	MICHIGAN	BCBSMI
2	500E811000	OTHER	MICHIGAN	BCBSMI
3	040D610940	OTHER	MICHIGAN	BCBSMI
4	080E810210	OTHER	MICHIGAN	BCBSMI
5	CD9268	OTHER	MICHIGAN	RRMC
6	2002924	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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