Provider Demographics
NPI:1093337024
Name:HEALTH PARTNERS OF WESTERN OHIO
Entity Type:Organization
Organization Name:HEALTH PARTNERS OF WESTERN OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:419-221-3072
Mailing Address - Street 1:405 WOODVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43605-2381
Mailing Address - Country:US
Mailing Address - Phone:419-249-1820
Mailing Address - Fax:419-249-1819
Practice Address - Street 1:405 WOODVILLE RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43605-2381
Practice Address - Country:US
Practice Address - Phone:419-249-1820
Practice Address - Fax:419-249-1819
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH PARTNERS OF WESTERN OHIO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy