Provider Demographics
NPI:1619997459
Name:NOES/PAULDING, LTD
Entity Type:Organization
Organization Name:NOES/PAULDING, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MANNY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARCELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-824-5063
Mailing Address - Street 1:PO BOX 638120
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-8120
Mailing Address - Country:US
Mailing Address - Phone:419-824-5063
Mailing Address - Fax:419-824-0216
Practice Address - Street 1:5800 MONROE ST
Practice Address - Street 2:BUILDING E #4
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2263
Practice Address - Country:US
Practice Address - Phone:419-824-3433
Practice Address - Fax:419-824-0216
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOES/PAULDING, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-21
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9309711Medicare PIN