Provider Demographics
NPI:1285729335
Name:ARTHRITIS ASSOCIATES OF NORTHWEST OHIO
Entity type:Organization
Organization Name:ARTHRITIS ASSOCIATES OF NORTHWEST OHIO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:D
Authorized Official - Last Name:PENIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-214-4214
Mailing Address - Street 1:4235 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4299
Mailing Address - Country:US
Mailing Address - Phone:419-473-3561
Mailing Address - Fax:
Practice Address - Street 1:3830 WOODLEY RD STE B
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1177
Practice Address - Country:US
Practice Address - Phone:419-473-9380
Practice Address - Fax:419-473-9515
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOLEDO CLINIC INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-04
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0543737Medicaid
OHCN1332OtherRAILROAD MEDICARE
OHCN1332OtherRAILROAD MEDICARE