Basic Information
Provider Information
NPI: 1093170417
EntityType: 2
ReplacementNPI:  
OrganizationName: REHABILITATION HOSPITAL OF NORTHWEST OHIO LLC
LastName:  
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Mailing Information
Address1: 5 E RIVER PARK PLACE E #460
Address2:  
City: FRESNO
State: CA
PostalCode: 937201560
CountryCode: US
TelephoneNumber: 5598922500
FaxNumber: 5598922442
Practice Location
Address1: 1455 WEST MEDICAL LOOP
Address2:  
City: TOLEDO
State: OH
PostalCode: 436148015
CountryCode: US
TelephoneNumber: 4192146600
FaxNumber: 4192146601
Other Information
ProviderEnumerationDate: 12/30/2015
LastUpdateDate: 12/17/2018
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: THOMAS
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName: L.
AuthorizedOfficialTitleorPosition: VICE PRESIDENT
AuthorizedOfficialTelephone: 7175915700
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
283X00000X  Y HospitalsRehabilitation Hospital 

No ID Information.


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