Provider Demographics
NPI:1174831010
Name:GASTRO-INTESTINAL ASSOCIATES, INC
Entity type:Organization
Organization Name:GASTRO-INTESTINAL ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHNIPKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-227-8209
Mailing Address - Street 1:2793 SHAWNEE RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45806-1444
Mailing Address - Country:US
Mailing Address - Phone:419-227-8209
Mailing Address - Fax:419-227-8224
Practice Address - Street 1:950 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-2479
Practice Address - Country:US
Practice Address - Phone:419-227-8209
Practice Address - Fax:419-227-8224
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GASTRO-INTESTINAL ASSOCIATES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9160622Medicare PIN