419-647-4584.
NPI 1750686770
Point of Service in Spencerville, OH

Q: What is 419-647-4584.'s NPI number?

The NPI number for 419-647-4584. is 1750686770. It was assigned to this organization in the NPPES registry on January 23, 2011.

Q: What is 419-647-4584.'s specialty?

The primary specialty registered for this NPI is Point of Service with taxonomy code 305S00000X.

Q: When was this NPI record last updated?

The NPPES record for 419-647-4584. was last updated on January 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 23, 2011

102 S BROADWAY ST, SPENCERVILLE, OH 45887(614) 582-9253 Get Directions Write a Review

NPPES record last updated: January 23, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About 419-647-4584. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

419-647-4584. (NPI 1750686770) is a healthcare organization registered as a point of service in Spencerville, Ohio and active in the NPI registry since January 2011. The organization lists Cathy Bates, Student, as its authorized official.

NPPES Registry Identity

NPI1750686770

Entity TypeOrganization

Primary Taxonomy305S00000X

Legal Business Name419-647-4584.

Location Address102 S BROADWAY STSpencerville, OH 45887-1267

Mailing Address102 S Broadway StSpencerville, OH 45887-1267

Phone(614) 582-9253

Organization SubpartYesParent: No

Authorized OfficialCathy BatesStudent · (419) 647-9999

Enumeration DateJanuary 23, 2011

✔ NPI 1750686770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPoint of ServiceManaged Care Organizations

Taxonomy Code305S00000X

License✔ Licensed in OH · 788776765655

Definition

This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.

102 S BROADWAY ST, Spencerville, OH 45887

Open in Google Maps ↗

Other Identifiers 1

Medicaid574184689203OH

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Y AND B DRUG INC

Pharmacy (Community/Retail Pharmacy)

102 S BROADWAY ST
SPENCERVILLE, OH 45887

Allen County (419) 647-4584

MRS. KATHLEEN MARY BURKHOLDER R.PH.

Pharmacist

102 S BROADWAY ST
SPENCERVILLE, OH 45887

Allen County (419) 647-4584

LORI MARIE RINGWALD

Pharmacist

102 S BROADWAY ST
SPENCERVILLE, OH 45887

Allen County (419) 647-4584

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 419-647-4584.'s NPI number?

The NPI number for 419-647-4584. is 1750686770. It was assigned to this organization in the NPPES registry on January 23, 2011.

Where is 419-647-4584. located?

419-647-4584. is located at 102 S Broadway St, Spencerville, OH 45887. The listed phone number is (614) 582-9253.

What is 419-647-4584.'s specialty?

The primary specialty registered for this NPI is Point of Service with taxonomy code 305S00000X.

When was this NPI record last updated?

The NPPES record for 419-647-4584. was last updated on January 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.