Provider Demographics
NPI:1497715361
Name:LIMA RADIOLOGICAL ASSOCIATES
Entity Type:Organization
Organization Name:LIMA RADIOLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-226-4382
Mailing Address - Street 1:5700 SOUTHWYCK BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1509
Mailing Address - Country:US
Mailing Address - Phone:800-288-8325
Mailing Address - Fax:419-866-5453
Practice Address - Street 1:730 W MARKET ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4602
Practice Address - Country:US
Practice Address - Phone:419-226-9023
Practice Address - Fax:419-866-5453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0117733Medicaid
OHCA3389OtherRAILROAD MEDICARE
027075600OtherFEDERAL BLACK LUNG PROG
OH000000075308OtherANTHEM BCBS
127520500OtherDEPT OF LABOR--(FECA)
027075600OtherFEDERAL BLACK LUNG PROG
127520500OtherDEPT OF LABOR--(FECA)
OHCA3389OtherRAILROAD MEDICARE
OH=========-01OtherBUREAU OF WORKERS COMP
OH=========022OtherMEDICAL MUTUAL OF OHIO
OH=========036OtherMEDICAL MUTUAL OF OHIO
OH=========-03OtherBUREAU OF WORKERS COMP