Provider Demographics
NPI:1609886258
Name:NORTHWEST OHIO PRIMARY CARE PHYSICIANS, INC.
Entity Type:Organization
Organization Name:NORTHWEST OHIO PRIMARY CARE PHYSICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-691-9001
Mailing Address - Street 1:3458 NAVARRE AVE
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3447
Mailing Address - Country:US
Mailing Address - Phone:419-698-3001
Mailing Address - Fax:419-698-0622
Practice Address - Street 1:3458 NAVARRE AVE
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3447
Practice Address - Country:US
Practice Address - Phone:419-698-3001
Practice Address - Fax:419-698-0622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35050630207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
386484086005OtherMEDICAL MUTUAL OF OHIO
01811OtherPARAMOUNT HEALTH CARE
1831120252OtherNPI
000000381184OtherBC/BS OHIO
OH0665909Medicaid
VE0586576Medicare ID - Type Unspecified
VE0586575Medicare ID - Type Unspecified
OH0665909Medicaid