Provider Demographics
NPI:1285815712
Name:IGNARSKI FAMILY MEDICINE, INC.
Entity Type:Organization
Organization Name:IGNARSKI FAMILY MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORY
Authorized Official - Middle Name:S
Authorized Official - Last Name:IGNARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:419-222-8432
Mailing Address - Street 1:750 W HIGH ST STE 390
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-3997
Mailing Address - Country:US
Mailing Address - Phone:419-222-8432
Mailing Address - Fax:419-222-9057
Practice Address - Street 1:750 W HIGH ST STE 390
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-3997
Practice Address - Country:US
Practice Address - Phone:419-222-8432
Practice Address - Fax:419-222-9057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076123261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2145806Medicaid
OHH03597Medicare UPIN
OH9352001Medicare PIN