Provider Demographics
NPI:1578569588
Name:LIMA MEMORIAL JOINT OPERATING COMPANY
Entity Type:Organization
Organization Name:LIMA MEMORIAL JOINT OPERATING COMPANY
Other - Org Name:LIMA MEMORIAL HEALTH SYSTEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:POHJALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-226-5163
Mailing Address - Street 1:1001 BELLEFONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2800
Mailing Address - Country:US
Mailing Address - Phone:419-226-5165
Mailing Address - Fax:419-226-5128
Practice Address - Street 1:1001 BELLEFONTAINE AVE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2800
Practice Address - Country:US
Practice Address - Phone:419-226-5165
Practice Address - Fax:419-226-5128
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIMA MEMORIAL JOINT OPERATING COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000174124OtherBLUE CROSS
0021501OtherAETNA
OH5184518Medicaid
05199OtherPARAMOUNT
0021501OtherAETNA
OH=========002OtherMEDICAL MUTUAL
OH5184518Medicaid
OH=========002OtherMEDICAL MUTUAL