Organization
LIMA MEMORIAL PROFESSIONAL CORPORATION
Active
Other names
Lima Memorial Diabetic Center at MedPark
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY UTZ (DIRECTOR IF LMP)
(419) 998-4668
Entity
Organization
Contact information
Practice address
525 N EASTOWN RD STE A, LIMA, OH 45807-2268
(419) 998-8291
(419) 998-8292
Mailing address
1001 BELLEFONTAINE AVE, LIMA, OH 45804-2800
(419) 998-4575
(419) 998-4586
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457474900
GROUP NPI
OH
05
—
2223703
—
OH
Enumeration date
05/22/2008
Last updated
09/24/2020
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