Grand Lake Podiatry Inc

LBN: Grand Lake Podiatry Inc
Grand Lake Podiatry Inc is an health care organization with primary practice located at 2624 Lexington Ave , Springfield OH 45505-2607. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as the primary health care specialty. Grand Lake Podiatry Inc can be contacted via phone (937) 322-3346, or through Benjamin-Swonger, Mary Katherine via phone (419) 586-7874.

Contact Information

Primary practice address
2624 Lexington Ave Springfield OH 45505-2607
Phone: (937) 322-3346
Fax: (937) 322-3348
Website:
Map and Directions
Authorized official contact:
Name: Benjamin-Swonger, Mary Katherine Doctor of Podiatric Medicine (DPM)
Phone: (419) 586-7874

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 36 002772 Ohio

Profile Details

NPI number 1184896177
LBN Legal business name Grand Lake Podiatry Inc
DBA Doing business as
Authorized official Benjamin-Swonger, Mary Katherine Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 31st, 2008
Last updated Jun 9th, 2011 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184896177 NPPES
Ohio MEDICAID 2544885

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