Provider Demographics
NPI:1003957408
Name:OHIO THERAPEUTIC HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:OHIO THERAPEUTIC HEALTH SERVICES, INC
Other - Org Name:MIAMI PHYSICAL REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ASCHETTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-999-1105
Mailing Address - Street 1:1470 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-3918
Mailing Address - Country:US
Mailing Address - Phone:419-999-1105
Mailing Address - Fax:419-999-1677
Practice Address - Street 1:601 W HIGH ST
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-2149
Practice Address - Country:US
Practice Address - Phone:937-773-3485
Practice Address - Fax:937-773-3485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2740010Medicaid
OH000000026713OtherANTHEM-PIQUA
OH000000026713OtherANTHEM-PIQUA
OH2740010Medicaid