Provider Demographics
NPI:1386128718
Name:TOLEDO CLINIC INCORPORATED
Entity type:Organization
Organization Name:TOLEDO CLINIC INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:SYLAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-473-3561
Mailing Address - Street 1:4126 N HOLLAND SYLVANIA RD STE 105
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3541
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 MEDICAL CENTER PKWY
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1921
Practice Address - Country:US
Practice Address - Phone:419-479-5605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOLEDO CLINIC INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-21
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy