Organization
NORTH COAST PROFESSIONAL COMPANY, LLC
Active
Other names
Firelands Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANIS A SHRIVER HCMBA (VICE PRESIDENT)
(419) 557-5540
Entity
Organization
Contact information
Practice address
1925 HAYES AVE, SANDUSKY, OH 44870-4737
(419) 557-5541
(419) 557-5542
Mailing address
1031 PIERCE ST, SANDUSKY, OH 44870-4669
(419) 557-5541
(419) 557-5542
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/18/2016
Last updated
01/20/2017
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