LICKING MEMORIAL PROFESSIONAL CORPORATION (NPI# 1326436510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326436510 |
| Entity Type | Organization |
| Organization Name | LICKING MEMORIAL PROFESSIONAL CORPORATION |
| Other Organization Name | LICKING MEMORIAL ORTHOPEDIC DME |
| Practice Address |
1717 W Main St Suite 201 Newark OH 43055-1347 |
| Practice Telephone | 2205642900 |
| Practice Fax Number | 2205642901 |
| Mailing Telephone | 2205642900 |
| Mailing Fax Number | 2205642901 |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2016-09-12 |
| Authorized Official Name | CYNTHIA L. WEBSTER (VP FINANCIAL SERVICES) |
| Authorized Official Telephone | 2205644000 |
| Is Organization Subpart | Y |
| Parent Organization Name | LICKING MEMORIAL PROFESSIONAL CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Licking Memorial Orthopedic DME | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053758631 | Licking Memorial Professional Corporation | Obstetrics & Gynecology | 270 Goosepond Road, Ste 102, Newark, OH 43055 | 2013-05-23 |
| 1740623628 | Licking Memorial Professional Corporation | Internal Medicine | 1272 West Main Street Bldg 2, Ste 4, Newark, OH 43055 | 2013-04-10 |
| 1457625758 | Licking Memorial Professional Corporation | Dermatology | 1272 West Main Street Bldg 2 Ste. 2, Newark, OH 43055 | 2012-03-05 |
| 1093955932 | Licking Memorial Professional Corporation | Surgery | 1 Healthy Pl Ste 202, Pataskala, OH 43062-7067 | 2009-03-05 |
| 1083646442 | Licking Memorial Professional Corporation | Otolaryngology | 88 Mcmillen Dr, Newark, OH 43055-5814 | 2006-07-07 |
| 1700291416 | Licking Memorial Professional Corporation | Dermatology | 1 Healthy Pl, Suite 205, Pataskala, OH 43062-7067 | 2014-06-23 |
| 1962684084 | Licking Memorial Professional Corporation | Family Medicine | 75 Mcmillen Dr, Newark, OH 43055-1808 | 2007-11-30 |
| 1952581274 | Licking Memorial Professional Corporation | Family Medicine | 151 Price Rd, Newark, OH 43055-3317 | 2007-11-05 |
| 1578755435 | Licking Memorial Professional Corporation | Psychiatry & Neurology | 1272 West Main Street, Bldg 2, Newark, OH 43055-2004 | 2007-08-15 |
| 1740472604 | Licking Memorial Professional Corporation | Dermatology | 270 Goosepond Rd, Newark, OH 43055-3104 | 2007-08-15 |
| Street Address |
1717 W MAIN ST SUITE 201 |
| City | NEWARK |
| State | OH |
| Zip Code | 43055-1347 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063411155 | Talya Greathouse | Family Medicine | 1717 W Main St, Suite 200, Newark, OH 43055-1347 | 2005-07-20 |
| 1811368822 | Anthony D'amico | Physician Assistant | 1717 W Main St, Suite 201, Newark, OH 43055 | 2015-10-16 |
| 1467729442 | Andrew Terlecky | Orthopaedic Surgery | 1717 W Main St, Suite 201, Newark, OH 43055 | 2011-11-19 |
| 1598781460 | Kevin Michael Ouweleen | Orthopaedic Surgery | 1717 W Main St, Suite 201, Newark, OH 43055-1347 | 2006-07-14 |
| 1316916752 | Robert Woollen Mueller | Orthopaedic Surgery | 1717 W Main St, Suite 201, Newark, OH 43055-1347 | 2006-03-17 |
| 1184606303 | Garth A Bennington | Family Medicine | 1717 W Main St, Suite 200, Newark, OH 43055-1347 | 2005-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770125585 | Jessica Danielle Dunkle | Case Manager/Care Coordinator | 15 N 3rd Street Suite 300, Newark, OH 43055 | 2019-10-14 |
| 1558910331 | Diana Cleland | Home Health Aide | 25 Western Rd, Apartment A, Newark, OH 43055 | 2019-09-05 |
| 1912424789 | Sandra Lou Fraley | Community/Behavioral Health | 15 North 3rd Street, Suite 300, Newark, OH 43055 | 2017-08-23 |
| 1215450911 | Caitlyn Thella Smith Elkins | Social Worker | 15 N. 3rd St., Newark, OH 43055 | 2017-07-25 |
| 1992227888 | Sierra Elizabeth Donley | Student in an Organized Health Care Education/Training Program | 140 W Church St, Newark, OH 43055 | 2017-07-12 |
| 1386170587 | Patricia Louise Fischer | Pharmacist | 1155 North 21rst Street, Newark, OH 43055 | 2017-05-08 |
| 1689120958 | Bebout Services, LLC | Home Health | 1325 Dayton Road Ne, Newark, OH 43055 | 2016-08-28 |
| 1750834594 | Laura Smith | Registered Nurse | 1445 West Main Street, Suite B, Newark, OH 43055 | 2016-07-28 |
| 1164807277 | Frank Kobe | Psychologist | 116 N. 21st Street, Newark, OH 43055 | 2015-07-30 |
| 1770975898 | Gentle Foot Care, Inc | Podiatrist | 1271 W Main Street, Bldg 1, Newark, OH 43055 | 2015-02-26 |
| Find all providers in zip 43055 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962035295 | Professional Technicians Incorporated | Durable Medical Equipment & Medical Supplies | 100 Biddle Ave Ste 200, Newark, DE 19702-3983 | 2020-02-14 |
| 1093363335 | North American Spine & Pain Consultants LLC Naspac | Durable Medical Equipment & Medical Supplies | 2600 Glasgow Ave Ste 126, Newark, DE 19702-4777 | 2019-08-29 |
| 1871074278 | Center for Interventional Pain & Spine, LLC | Durable Medical Equipment & Medical Supplies | 4701 Ogletown Stanton Rd Ste 1200, Newark, DE 19713-2079 | 2018-08-23 |
| 1710406293 | Bmrr Corporation | Durable Medical Equipment & Medical Supplies | 664 Mt Prospect Ave, Newark, NJ 07104 | 2017-09-15 |
| 1073032843 | Siddhivinayak Inc | Durable Medical Equipment & Medical Supplies | 90 Bergen St Ste 1600, Newark, NJ 07103-2425 | 2017-09-13 |
| 1760909501 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 140 42 Ferry St, Newark, NJ 07105 | 2017-08-23 |
| 1023532710 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 140 Ferry St # 42, Newark, NJ 07105-2113 | 2017-08-03 |
| 1700326709 | Shie Consulting LLC | Durable Medical Equipment & Medical Supplies | 200 Continental Dr Ste 401, Newark, DE 19713-4337 | 2017-02-24 |
| 1932646783 | Helping Hands Medical Supply | Durable Medical Equipment & Medical Supplies | 351-353 Avon Avenue, Rear Door, Newark, NJ 07108 | 2017-01-31 |
| 1457778276 | Delaware Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 366 E Chestnut Hill Rd, Newark, DE 19713-3737 | 2014-03-19 |
| Find all providers in NEWARK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.