PROMEDICA HEALTH SYSTEM NPI 1285172163

NPI Information

PROMEDICA HEALTH SYSTEM is a medical physician assistant in Sylvania, OH. PROMEDICA HEALTH SYSTEM NPI is 1285172163. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5308 HARROUN RD STE 280
SYLVANIA, OH
ZIP 43560-190
Phone: (419) 824-1785
Fax: (419) 824-5953

The provider's authorized official is Courtney Moyer .
The authorized official title is Physician Assistant and has the following contact phone number (419) 824-1785.

The CLIA number assigned to this NPI record is 36D0923387 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/10/2017 and was last updated on 2/10/2017.

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:

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