Provider Demographics
NPI:1861981656
Name:OHIO LIVING PALLIATIVE CARE GREATER TOLEDO LLC
Entity type:Organization
Organization Name:OHIO LIVING PALLIATIVE CARE GREATER TOLEDO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:GUMINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-888-7800
Mailing Address - Street 1:9200 WORTHINGTON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7240
Mailing Address - Country:US
Mailing Address - Phone:614-888-7800
Mailing Address - Fax:614-888-6864
Practice Address - Street 1:1730 S REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1402
Practice Address - Country:US
Practice Address - Phone:419-865-1499
Practice Address - Fax:419-865-4227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty