Provider Demographics
NPI:1932502606
Name:LUCAS COUNTY AUDITOR
Entity Type:Organization
Organization Name:LUCAS COUNTY AUDITOR
Other - Org Name:TOLEDO-LUCAS COUNTY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNTY HEALTH COMMISSIONER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:GROSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-213-4049
Mailing Address - Street 1:635 N ERIE ST
Mailing Address - Street 2:BILLING RM. 272
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-5317
Mailing Address - Country:US
Mailing Address - Phone:419-213-4049
Mailing Address - Fax:419-213-4220
Practice Address - Street 1:635 N ERIE ST
Practice Address - Street 2:BILLING RM. 272
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-5317
Practice Address - Country:US
Practice Address - Phone:419-213-4049
Practice Address - Fax:419-213-4220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2015-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local