Provider Demographics
NPI:1134112469
Name:FAMILY PHYSICIANS OF LIMA INC
Entity Type:Organization
Organization Name:FAMILY PHYSICIANS OF LIMA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KARRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:KRENDL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-991-7805
Mailing Address - Street 1:2875 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-2510
Mailing Address - Country:US
Mailing Address - Phone:419-991-7805
Mailing Address - Fax:419-991-7862
Practice Address - Street 1:2875 W ELM ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-2510
Practice Address - Country:US
Practice Address - Phone:419-991-7805
Practice Address - Fax:419-991-7862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1215941711OtherNPI# FOR DR. SHARP
OH0823854Medicaid
OH1831183896OtherNPI# FOR DR. KRENDL
OH1184619595OtherNPI# FOR ELISE CLARK,CNP
OH1669550182OtherGROUP NPI# SATELLITE OFFI
OH1184619595OtherNPI# FOR ELISE CLARK,CNP
OH0823854Medicaid
OH1346235728OtherNPI# FOR DR. GAYNIER