Provider Demographics
NPI:1003080862
Name:THE TOLEDO HOSPITAL
Entity Type:Organization
Organization Name:THE TOLEDO HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-824-7264
Mailing Address - Street 1:5855 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2269
Mailing Address - Country:US
Mailing Address - Phone:419-824-7264
Mailing Address - Fax:419-824-7359
Practice Address - Street 1:4235 SECOR RD
Practice Address - Street 2:PROMEDICA URGENT CARE
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4231
Practice Address - Country:US
Practice Address - Phone:419-720-3989
Practice Address - Fax:419-720-3990
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE TOLEDO HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8822662Medicaid
OH3600681Medicare PIN