Provider Demographics
NPI:1528412145
Name:UNIVERSITY OF TOLEDO MEDICAL CENTER
Entity Type:Organization
Organization Name:UNIVERSITY OF TOLEDO MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:SIRINE
Authorized Official - Middle Name:SAMIR
Authorized Official - Last Name:SHOUKAIR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:419-508-9844
Mailing Address - Street 1:2321 SAINT JAMES WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1227
Mailing Address - Country:US
Mailing Address - Phone:419-508-9844
Mailing Address - Fax:
Practice Address - Street 1:3000 ARLINGTON AVE
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:419-383-6390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03232835183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty