Provider Demographics
NPI:1184751323
Name:ADULT PRIMARY CARE INC
Entity type:Organization
Organization Name:ADULT PRIMARY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMABEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-824-5063
Mailing Address - Street 1:3900 SUNFOREST CT
Mailing Address - Street 2:SUITE 240
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4475
Mailing Address - Country:US
Mailing Address - Phone:419-472-3126
Mailing Address - Fax:419-472-3437
Practice Address - Street 1:3900 SUNFOREST CT
Practice Address - Street 2:SUITE 240
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4475
Practice Address - Country:US
Practice Address - Phone:419-472-3126
Practice Address - Fax:419-472-3437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2128138Medicaid
OH2128138Medicaid