Organization
REYNOLDS ROAD SURGICAL CENTER LTD
Active
Other names
Wildwood Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY G SHIRER CASC (MANAGER OF FINANCE)
(419) 578-7500
Entity
Organization
Contact information
Practice address
2865 N REYNOLDS RD, SUITE 190, TOLEDO, OH 43615-2068
(419) 578-7500
(419) 539-6320
Mailing address
2865 N REYNOLDS RD, SUITE 190, TOLEDO, OH 43615-2068
(419) 578-7500
(419) 539-6320
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0437AS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000156919
BCBS
—
01
—
03422
PARAMOUNT HEALTHCARE
OH
05
—
2059669
—
OH
Enumeration date
04/04/2006
Last updated
04/22/2014
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