Organization
PHARMACY COUNTER, LLC
Active
Parent organization
PROMEDICA PHYSICIANS GROUP, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROMEDICA PHYSICIANS GROUP, INC.
Authorized official
MS. MISSY CROSS (GENERAL MANAGER)
(419) 473-1493
Entity
Organization
Contact information
Practice address
1661 HOLLAND RD, SUITE 400, MAUMEE, OH 43537-4207
(419) 720-2005
(419) 720-2006
Mailing address
2655 W CENTRAL AVE, TOLEDO, OH 43606-3550
(419) 473-1493
(419) 474-7137
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115526
—
OH
Enumeration date
11/02/2013
Last updated
04/12/2018
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