Community Hospitals and Wellness Centers Internal Medicine Clinic
Organization Active NPI Internal Medicine Physician · Wauseon, OH
NPI 1376671065 · NPPES record last updated Feb 4, 2008
Key facts
- NPI
- 1376671065
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- COMMUNITY HOSPITALS AND WELLNESS CENTERS INTERNAL MEDICINE CLINIC
- Practice address
- 447 N Shoop Ave
Wauseon, OH 43567-1261 - Phone
- (419) 337-7980
- Fax
- (419) 337-8265
- NPI assigned
- Mar 2, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Philip L. Ennen
- Title
- President
- Phone
- (419) 636-1131
Other NPIs on the same Medicare enrollment 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040226001067 | OH | Part B Supplier - Clinic/Group Practice | 7517878093 |
Receives reassigned benefits from 48 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Archbold, OH; Bryan, OH; Montpelier, OH |
National Provider Directory
Locations
447 N Shoop Ave
Wauseon, OH 43567
Phone (419) 337-7980
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
447 N Shoop Ave
Wauseon, OH 43567-1261
Mailing address
447 N Shoop Ave
Wauseon, OH 43567-1261
Phone (419) 337-7980
Other providers in Wauseon, OH
- City of Wauseon
- Anne Clark
- Leslie S Clemensen
- Kimberly Sue Clingaman
- Kelly Cohoon
- Priscilla Conti
- Tasha Cook
- Gregory S. Cousino
- Stephen Andrew Cox
- Jill Crossgrove-Murillo
All providers in Wauseon, OH · Internal Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.