Provider Demographics
NPI:1063639243
Name:UNIVERSITY OF TOLEDO
Entity Type:Organization
Organization Name:UNIVERSITY OF TOLEDO
Other - Org Name:STUDENT MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR.DIRECTOR, UNIVERSITY HEALTH SERV
Authorized Official - Prefix:MS
Authorized Official - First Name:NORINE
Authorized Official - Middle Name:THERESE
Authorized Official - Last Name:WASIELEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN MBA
Authorized Official - Phone:419-530-3479
Mailing Address - Street 1:2801 W BANCROFT ST
Mailing Address - Street 2:MS 513
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3328
Mailing Address - Country:US
Mailing Address - Phone:419-530-3479
Mailing Address - Fax:419-530-3418
Practice Address - Street 1:2801 W BANCROFT ST
Practice Address - Street 2:MS 513
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3328
Practice Address - Country:US
Practice Address - Phone:419-530-3479
Practice Address - Fax:419-530-3418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health