Provider Demographics
NPI:1699848689
Name:BLANCHARD VALLEY SURGICAL SPECIALISTS INC
Entity Type:Organization
Organization Name:BLANCHARD VALLEY SURGICAL SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BORKOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-423-0424
Mailing Address - Street 1:1725 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1322
Mailing Address - Country:US
Mailing Address - Phone:419-423-0424
Mailing Address - Fax:419-423-0641
Practice Address - Street 1:1725 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1322
Practice Address - Country:US
Practice Address - Phone:419-423-0424
Practice Address - Fax:419-423-0641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
9297381Medicare PIN