| Organization Name: | PROMEDICA CENTRAL PHYSICIANS LLC |
| NPI Number: | 1871912410 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMY DWYER (CREDENTIALING SUPERVISOR) |
| Mailing Address: | 5085 Monroe St Toledo |
| State: | OH US |
| Postal Code: | 436233455 |
| Phone Number: | 4197761004 |
| Fax Number: | 4197761020 |
| NPI Enumeration Date: | 04/10/2014 |
| NPI Last Update Date: | 04/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156F00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A broad category grouping different kinds of technologists and technicians. See individual definitions. |