Provider Demographics
NPI:1225039209
Name:LIMA FAMILY CARE INC
Entity Type:Organization
Organization Name:LIMA FAMILY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:419-227-5879
Mailing Address - Street 1:830 W HIGH ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-3971
Mailing Address - Country:US
Mailing Address - Phone:419-227-5879
Mailing Address - Fax:419-227-5879
Practice Address - Street 1:830 W HIGH ST
Practice Address - Street 2:SUITE 307
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-3971
Practice Address - Country:US
Practice Address - Phone:419-227-5879
Practice Address - Fax:419-227-5879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35078247V207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0198861Medicaid
OH0198861Medicaid
OH0198861Medicaid