Provider Demographics
NPI:1265583306
Name:NORTH CENTRAL OHIO MEDICAL SERV.
Entity type:Organization
Organization Name:NORTH CENTRAL OHIO MEDICAL SERV.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:419-626-6091
Mailing Address - Street 1:3006 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-5381
Mailing Address - Country:US
Mailing Address - Phone:419-626-6091
Mailing Address - Fax:419-626-5640
Practice Address - Street 1:3006 CAMPBELL ST
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-5381
Practice Address - Country:US
Practice Address - Phone:419-626-6091
Practice Address - Fax:419-626-5640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0612411Medicaid
OH2674815Medicaid
OH0613036Medicaid
OHAH0601285Medicare ID - Type UnspecifiedDR S AHLUWALIA
OHD14635Medicare UPIN
OHA82355Medicare UPIN
OH0612411Medicaid
OH0613036Medicaid
OH2674815Medicaid