Basic Information
| Provider Information | |||||||||
| NPI: | 1801198916 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OHIO VISION OF TOLEDO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2740 NAVARRE AVE | ||||||||
| Address2: | |||||||||
| City: | OREGON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436163216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4196934444 | ||||||||
| FaxNumber: | 4196972149 | ||||||||
| Practice Location | |||||||||
| Address1: | 7416 W CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436171123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4196934444 | ||||||||
| FaxNumber: | 4196972149 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2010 | ||||||||
| LastUpdateDate: | 02/01/2011 | ||||||||
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| AuthorizedOfficialLastName: | JANKOWSKI | ||||||||
| AuthorizedOfficialFirstName: | JESSICA | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | AR MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4196973634 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 4585460001 | OH | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | 4585460001 | 01 | OH | SUPPLIER NUMBER | OTHER |