Provider Demographics
NPI:1336144732
Name:LIMA MEMORIAL JOINT OPERATING COMPANY
Entity type:Organization
Organization Name:LIMA MEMORIAL JOINT OPERATING COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BUIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-483-4040
Mailing Address - Street 1:1001 BELLEFONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2800
Mailing Address - Country:US
Mailing Address - Phone:419-226-5165
Mailing Address - Fax:419-226-5128
Practice Address - Street 1:1001 BELLEFONTAINE AVE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2800
Practice Address - Country:US
Practice Address - Phone:419-226-5165
Practice Address - Fax:419-226-5128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5184518Medicaid
BLUE CROSSOther000000174124
PARAMOUNTOther05199
AETNAOther0021501
OH360009Medicare ID - Type UnspecifiedPART A & B