Provider Demographics
NPI:1306508775
Name:LOBMILLER, SAMANTHA ANN
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:ANN
Last Name:LOBMILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 STATE ROUTE 229
Mailing Address - Street 2:
Mailing Address - City:ASHLEY
Mailing Address - State:OH
Mailing Address - Zip Code:43003-8701
Mailing Address - Country:US
Mailing Address - Phone:740-816-8607
Mailing Address - Fax:
Practice Address - Street 1:2911 US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:CARDINGTON
Practice Address - State:OH
Practice Address - Zip Code:43315-9790
Practice Address - Country:US
Practice Address - Phone:740-272-3499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH581549Medicaid