Toledo Community Lithotripter Corp.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

417 Issued in OH

Legal business name

TOLEDO COMMUNITY LITHOTRIPTER CORP.

Practice address

3158 W Central Ave
Toledo, OH 43606-2920

Phone

(419) 531-3538

Fax

(419) 531-2807

NPI assigned

Apr 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. G. Mark Seal, M.D.

Title

President

Phone

(419) 725-4400

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811951452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3158 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436062920",
            "telephone_number": "419-531-3538",
            "fax_number": "419-531-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3158 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436062920",
            "telephone_number": "419-531-3538",
            "fax_number": "419-531-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOLEDO COMMUNITY LITHOTRIPTER CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SEAL",
        "authorized_official_first_name": "G.",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-725-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OH",
            "license": "417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2124675",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE COMM. HEALTH PLAN",
            "identifier": "604727",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "01767",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "156605",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0986054",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMOH",
            "identifier": "3610521",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Toledo Elite Transportation

• Ambulatory Surgical Clinic/Center in Toledo, OH
• Providers in Toledo, OH by specialty
• Ambulatory Surgical Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.