Provider Demographics
NPI:1447844774
Name:GASTRO INTESTINAL ASSOCIATES, INC
Entity type:Organization
Organization Name:GASTRO INTESTINAL ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SOLOMON
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:419-222-6007
Practice Address - Street 1:109 S BROAD ST
Practice Address - Street 2:
Practice Address - City:KALIDA
Practice Address - State:OH
Practice Address - Zip Code:45853-2038
Practice Address - Country:US
Practice Address - Phone:419-227-8209
Practice Address - Fax:419-222-6007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-26
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty