Provider Demographics
NPI:1487334991
Name:MEDWIZ OF OHIO LLC
Entity type:Organization
Organization Name:MEDWIZ OF OHIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ARON
Authorized Official - Middle Name:
Authorized Official - Last Name:UNGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-624-8080
Mailing Address - Street 1:167 ROUTE 304
Mailing Address - Street 2:
Mailing Address - City:BARDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2050
Mailing Address - Country:US
Mailing Address - Phone:419-219-4100
Mailing Address - Fax:419-219-4111
Practice Address - Street 1:4755 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-6422
Practice Address - Country:US
Practice Address - Phone:419-219-4100
Practice Address - Fax:419-219-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy