Provider Demographics
NPI:1073528741
Name:NORTHWEST OHIO PRIMARY CARE PHYSICIANS, INC.
Entity Type:Organization
Organization Name:NORTHWEST OHIO PRIMARY CARE PHYSICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-849-3443
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:WOODVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43469-0189
Mailing Address - Country:US
Mailing Address - Phone:419-849-3443
Mailing Address - Fax:419-849-3674
Practice Address - Street 1:104 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:OH
Practice Address - Zip Code:43469-1209
Practice Address - Country:US
Practice Address - Phone:419-849-3443
Practice Address - Fax:419-849-3674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
605319OtherBUCKEYE COMMUNITY HEALTH
288369063011OtherMEDICAL MUTUAL OF OHIO
OH0188121Medicaid
P00247530OtherRR MEDICARE
04902OtherPARMOUNT HEALTH CARE
OH000000377346OtherBC/BS
P00247530OtherRR MEDICARE
KA0378695Medicare ID - Type Unspecified