Provider Demographics
NPI:1992248496
Name:JAMIE HOPPE
Entity type:Organization
Organization Name:JAMIE HOPPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-603-6147
Mailing Address - Street 1:1650 EBER RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-9793
Mailing Address - Country:US
Mailing Address - Phone:419-866-4328
Mailing Address - Fax:
Practice Address - Street 1:715 S TAFT AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-3237
Practice Address - Country:US
Practice Address - Phone:419-332-7321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004910RX282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural