Provider Demographics
NPI:1851570709
Name:LENEHAN HEART HEALTHCARE, INC
Entity Type:Organization
Organization Name:LENEHAN HEART HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:LENEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACC
Authorized Official - Phone:419-774-1000
Mailing Address - Street 1:1221 S TRIMBLE RD BLDG C-3
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907
Mailing Address - Country:US
Mailing Address - Phone:419-774-1000
Mailing Address - Fax:419-774-1001
Practice Address - Street 1:1221 S TRIMBLE RD BLDG C-3
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-2211
Practice Address - Country:US
Practice Address - Phone:419-774-1000
Practice Address - Fax:419-774-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH49759207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9337981Medicare PIN