Provider Demographics
NPI:1861511008
Name:ORTHOPAEDIC INSTITUTE OF OHIO, INC.
Entity Type:Organization
Organization Name:ORTHOPAEDIC INSTITUTE OF OHIO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ACKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-222-6622
Mailing Address - Street 1:801 MEDICAL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-4099
Mailing Address - Country:US
Mailing Address - Phone:419-222-6622
Mailing Address - Fax:
Practice Address - Street 1:1275 GREENVILLE RD
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:OH
Practice Address - Zip Code:45885-9352
Practice Address - Country:US
Practice Address - Phone:419-394-4636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2030420Medicaid
0369150002Medicare NSC
OH9292422Medicare ID - Type Unspecified