Organization
PROMEDICA CONTINUING CARE SERVICES CORP
Active
Other names
ProMedica Home Medical Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
GLADEEN A ROBERTS (PRESIDENT)
(419) 469-3780
Entity
Organization
Contact information
Practice address
1200 RALSTON AVE, DEFIANCE, OH 43512-1396
(419) 783-6973
(419) 783-4430
Mailing address
1801 RICHARDS RD, TOLEDO, OH 43607-1037
(419) 469-3780
(419) 469-3781
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000155945
ANTHEM
OH
05
—
0259250
—
OH
01
—
10133
PARAMOUNT HEALTH CARE
OH
01
—
139856
CARE CHOICES
MI
01
—
4405016
MI MEDICAID
MI
01
—
707795
BUCKEYE COMMUNITY
OH
01
—
81337
NPN
OH
Enumeration date
09/19/2005
Last updated
02/10/2011
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