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Contact Information

OTTERBEIN PERRYSBURG LLC
3529 RIVERS EDGE DRIVE
PERRYSBURG, OH43551
 Phone: 419-874-2428
 Fax: 419-872-8464
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for OTTERBEIN PERRYSBURG LLC

NPI # 1003939786
LBN Legal business name OTTERBEIN PERRYSBURG LLC
Authorized official JAMES GREEN - (TREASURER & CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 04/09/2007
Last updated 02/09/2015 - About 11 years ago
Identifiers
OH License # 2480N
OH Medicaid 2768107
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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