Provider Demographics
NPI:1962454199
Name:VAN HARLINGEN INC
Entity Type:Organization
Organization Name:VAN HARLINGEN INC
Other - Org Name:SHAW & OTT MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:VAN HARLINGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-524-4388
Mailing Address - Street 1:270 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1200
Mailing Address - Country:US
Mailing Address - Phone:419-524-4388
Mailing Address - Fax:419-525-2354
Practice Address - Street 1:270 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1200
Practice Address - Country:US
Practice Address - Phone:419-524-4388
Practice Address - Fax:419-525-2354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0399313Medicaid
OH0399313Medicaid