Provider Demographics
NPI:1801198916
Name:OHIO VISION OF TOLEDO
Entity Type:Organization
Organization Name:OHIO VISION OF TOLEDO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:JANKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-697-3634
Mailing Address - Street 1:2740 NAVARRE AVE
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3216
Mailing Address - Country:US
Mailing Address - Phone:419-693-4444
Mailing Address - Fax:419-697-2149
Practice Address - Street 1:7416 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1123
Practice Address - Country:US
Practice Address - Phone:419-693-4444
Practice Address - Fax:419-697-2149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4585460001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4585460001OtherSUPPLIER NUMBER