Provider Demographics
NPI:1457314502
Name:MEDICAL UNIVERSITY OF OHIO AT TOLEDO
Entity Type:Organization
Organization Name:MEDICAL UNIVERSITY OF OHIO AT TOLEDO
Other - Org Name:UNIVERSITY OF TOLEDO MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO UNIVERSITY OF TOLEDO MEDICAL CE
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SWAINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-383-6332
Mailing Address - Street 1:3000 ARLINGTON AVE # MS 1166
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2595
Mailing Address - Country:US
Mailing Address - Phone:419-383-3714
Mailing Address - Fax:419-383-3014
Practice Address - Street 1:3000 ARLINGTON AVE # MS 1166
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2595
Practice Address - Country:US
Practice Address - Phone:419-383-4000
Practice Address - Fax:419-383-3014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH36-S048Medicare ID - Type UnspecifiedPYSCHIATRIC UNIT