Provider Demographics
NPI:1700945193
Name:OHIO THERAPEUTIC HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:OHIO THERAPEUTIC HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ASCHETTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-999-1105
Mailing Address - Street 1:1470 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-3918
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3063 W ELM ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-2514
Practice Address - Country:US
Practice Address - Phone:419-999-1105
Practice Address - Fax:419-999-1677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000026713OtherANTHEM-PIQUA
OH000000026717OtherANTHEM-LIMA
OH2721200Medicaid
OH000000026766OtherANTHEM-SIDNEY
OH000000026766OtherANTHEM-SIDNEY
OH2721200Medicaid
OH=========-009OtherMEDICAL MUT
OHOH9296241Medicare ID - Type UnspecifiedMEDICARE GRP#-SIDNEY
OH000000026717OtherANTHEM-LIMA
OH000000026713OtherANTHEM-PIQUA