Aetna "Select Provider" Listing - High-Tech Radiology, OH 43537 Bay Park Community Memorial Hosptial* 7077258, 5361477 2801 Bay Park Drive, OH 43616 Phone: 419-690-7900 Svcs: MR, CNM, CT Mercy St. Charles Hospital* 6461060, 3625 2600 Navarre Avenue, OH 43616 Phone: 419-696-7200 Svcs: MR, CT, PET Flower Hospital* 6461040, 3550 5200 Harroun Road, OH 43560 Phone: 419-824-1444 Medical Imaging* 7280285, 5591210 5660 Monroe Street, Suite 7, OH 43560 Phone: 419-882-3333 Hours: M-F 8am-6pm Imaging Central, LLC* 7218530, 7311724 7111 West Central Avenue, OH 43617 Phone: 419-841-7070 / Fax: 419-843-6686 Hours: M,T,F 8am-5pm, W, Th 8am-8pm, PET Mercy St. Anne Hospital* 6461055, 1141711 3404 West Avenue, OH 43623 Phone: 419-407-2663 6461070, 199100, OH 43608 Svcs: MR, CT PDI, LLC* 7019883, 8863732 4126 North Holland Avenue, OH 43623 7019883, 2612676 4126 North Holland Road, OH 43623 Svcs: OMR The Imaging 7485874, 2362821 4447 Talmadge Road, Suite H, OH 43623 Phone: 419-292-0400 / Fax: 419-292-0409 Hours: M-Sun 6am-11pm The Clinic*, OH 43623 Hours: M-F 8:15am-5pm The Hospital*, OH 43606 Hours: 24 hours/7days, CNM, CT The University of Medical, OH 43614 SENECA COUNTY Tiffin Advanced Medical Imaging* 7846784, 9393268 3101 West U.S. Hwy. 224, Suite D Tiffin, OH 44883 Phone: 419-448-6848 / Fax: 419-448-3810 Svcs: MR, CT WOOD COUNTY Bowling Green Wood County Hospital 6460205, 159184 950 West Wooster Street Bowling Green, OH 43402 Phone: 419-354-8900 Svcs: MR, CT, PET Note(s): These procedures may require pre-authorization. Aetna's radiology management vendors may have more current information that will supersede the information contained within this List. Effective January 1, 2012, Aetna requires all providers administering high-tech radiology services to be accredited by the American College of Radiology and/or the Intersocietal Accreditation Commission. Any provider performing these services who has not been accredited at the time of service will not be eligible for payment. Therefore, Aetna s radiology management vendors will offer alternative providers who have been determined to be accredited in accordance with these standards. MR - Closed MRI OMR - Open MRI CNM - Cardio Nuclear Medicine CT - CAT Scan PET - Positron Emission Tomography
Aetna "Select Provider" Listing - Low-Tech Radiology Bay Park Community Memorial Hosptial* 7077258, 5361477 2801 Bay Park Drive, OH 43616 Phone: 419-690-7900 Flower Hospital* 6461040, 3550 5200 Harroun Road, OH 43560 Phone: 419-824-1444, US, M Medical Imaging* 7280285, 5591210 5660 Monroe Street, Suite 7, OH 43560 Phone: 419-882-3333 6461070, 199100, OH 43608 PDI, LLC* 7019883, 8863732 4126 North Holland Avenue, OH 43623 7019883, 2612676 4126 North Holland Road, OH 43623 Ultrasound Institute & Men's Health Ctr.* 5679277, 6812743 4417 North Holland Road, Suite B, OH 43623 Phone: 419-841-7766 / Fax: 419-841-7555 Hours: M,W,Th 8am-5pm, F8am - 2pm Svcs: US The Clinic*, OH 43623 Hours: M-F 8:15am-5pm The Hospital*, OH 43606 The University of Medical, OH 43614 SANDUSKY COUNTY Bellevue The Bellevue Hospital* 6460185, 7912320 1400 West Main Street Bellevue, OH 44811 Phone: 419-483-4040 / Fax: 419-483-9718 SENECA COUNTY Tiffin Advanced Medical Imaging* 7846784, 9393268 3101 West U.S. Hwy. 224, Suite D Tiffin, OH 44883 Phone: 419-448-6848 / Fax: 419-448-3810, FL, US, S X - X-Ray FL - Fluoroscopy US - Ultrasound S - Sonogram BD - Bone Density M - Mammography
ALLEN COUNTY Delphos Delphos Ambulatory Surgery 9943123, 8112081 1775 East 5th Street Delphos, OH 45833 Phone: 419-692-1055 Lima Eye Surgery Center of Western Ohio* 5047656, 111836 855 West Market Street Lima, OH 45805 Phone: 419-228-7432 Svcs: OPT The Endoscopy Center of West Central Ohio* 9355168, 9163278 2793 Shawnee Road Lima, OH 45806 Phone: 910-295-7248 Svcs: EN West Central Ambulatory Surgery & Endoscopy 7464529, 2741356 770 West High Street, Suite 100 Lima, OH 45801 Phone: 419-226-8700 CRAWFORD COUNTY Bucyrus Bucyrus Community Hospital* 6460215, 170365 629 North Sandusky Avenue Hours: 24/7 hours 6460215, 159188 629 North Sandusky Street Hours: 24/7 hours ERIE COUNTY Sandusky NovaMed Surgery Center of Sandusky, L.L.C.* 5674637, 9460910 2616 Hayes Avenue Sandusky, OH 44870 Phone: 419-626-2800 Hours: M-Th 8am - 5pm, F 8am - 4pm Aetna "Select Provider" Listing - Ambulatory Surgery HANCOCK COUNTY Findlay Findlay Surgery Center 7773063, 2561164 1709 Medical Blvd. Findlay, OH 45840 Phone: 419-429-0409 Hours: M-F 5:30am - 5pm HURON COUNTY Norwalk Podiatric Surgi-Center, INC 5816647, 3640975 64 Executive Pkwy. Norwalk, OH 44857 Phone: 419-663-3338 Svcs: ORP 5121619, 1111889 485 West Dussel Drive, OH 43537 Phone: 419-891-1391, OH 43537 Surgi+Care* 5115632, 3050953 5959 Monclova Road, OH 43537 Phone: 419-897-5501 The Eye Institute of Northwestern Ohio, 8461565, 3402699 3509 Briarfield Blvd., OH 43537 Phone: 419-865-3866 / Fax: 419-865-3451 Hours: M-F 8:30am - 5pm Svcs: OPT 5121619, 50502 2740 Navarre Avenue, OH 43616 Phone: 419-693-4444 / Fax: 419-697-2149 Mercy St. Anne Hospital* 6461055, 1141711 3404 West Avenue, OH 43623 Phone: 419-407-2663 6461070, 5624, OH 43608 Northwest Ohio Endoscopy 5907678, 5961127 4841 Monroe Street, Suite 111, OH 43623 Phone: 419-474-3949 Hours: M-F 7am - 2pm Svcs: EN 5121619, 469504 1835 South Reynolds Road, OH 43614 Phone: 419-382-6710 5121619, 473454 5733 Lewis Avenue, OH 43612 Phone: 419-269-8888 Parkway Surgical Center, Ltd.* 8462890, 511669 3500 Executive Pkwy., OH 43606 Phone: 419-531-8349 / Fax: 419-531-6833 Reconstructive & Aesthetic Surgery Center, 7644476, 7701196 2865 North Reynolds Road, Suite 250, OH 43615 Phone: 419-534-6551 / Fax: 419-534-6563 Hours: M-Th 8am - 5pm, F 8am - 4pm Surgery Center at Regency Park* 8462720, 253501 2000 Regency Court, Suite 101, OH 43623 Phone: 419-882-0003 Hours: M-F 6:30am - 4:30pm The Hospital*, OH 43606 Hours: 24 hour/7days The University of Medical, OH 43614 Clinic Outpatient Surgery 4433146, 3514, OH 43623 Phone: 419-479-5650 Hours: M-F 6:30am - 4pm West Central Surgical Center, LLC* 7742719, 8410490 7055 West Central Avenue, OH 43617 Phone: 419-843-1370 / Fax: 419-843-1362 Hours: M-F 7am - 3:30pm GEN - General Surgery EN - Endoscopy INF - Infertility LT - Lithotripsy OPT - Opthalmology ORP - Orthopedics BA - Bariatric UR - Urology
Wildwood Surgical 5863584, 1431127 2865 North Reynolds Road, Suite 190, OH 43615 Phone: 419-578-7500 / Fax: 419-539-6320 Hours: M-F 8am - 4:30pm Aetna "Select Provider" Listing - Ambulatory Surgery Note(s): Some ambulatory procedures require the physician to notify Aetna prior to performing services (e.g., colonoscopy and other scope procedures). These procedures were not used to determine this listing. GEN - General Surgery EN - Endoscopy INF - Infertility LT - Lithotripsy OPT - Opthalmology ORP - Orthopedics BA - Bariatric UR - Urology 2 of 2
ALLEN COUNTY Lima Sleep Center of Lima* 7890485, 9792381 528 West Market Street, Suite 200 Lima, OH 45801 Phone: 419-227-7878 / Fax: 419-227-1370 Hours: M,T,F 8:30am-4pm, W 8:30am-4:30pm, Th 9am CRAWFORD COUNTY Bucyrus Bucyrus Community Hospital* 6460215, 170365 629 North Sandusky Avenue 6460215, 159188 629 North Sandusky Street ERIE COUNTY Sandusky Northern Ohio Medical Specialists 7353223, 6323518 2500 West Strub Road Sandusky, OH 44870 Phone: 419-626-6161 FULTON COUNTY Wauseon The Clinic* 8462845, 6407 725 South Shoop Avenue Wauseon, OH 43567 Phone: 419-330-2700 HANCOCK COUNTY Findlay Blanchard Valley Hospital* 6460645, 8570198 1900 South Main Street Findlay, OH 45840 Phone: 419-423-4500 5072600, 205558 1661 Holland Road, OH 43537 Phone: 419-843-7800, OH 43537 Aetna "Select Provider" Listing - Sleep Studies Sleep Disorders Center, Ltd.* 7520272, 1512548 1661 Holland Road, Suite 300, OH 43537 Phone: 419-794-8200 / Fax: 419-724-1892 5072600, 58262 1050 Isaac Streets Drive, Suite 139, OH 43616 Phone: 419-843-7800 5072600, 6960 3841 Navarre Avenue, OH 43616 Phone: 419-251-3039 / Fax: 419-251-6763 Sleep Disorders Center, Ltd.* 7520272, 4981114 2702 Navarre Avenue, OH 43616 Phone: 419-693-9727 Primary Care Center, 7643204, 7202142 7640 Avenue, Suite E, OH 43560 Phone: 419-473-2273 / Fax: 419-473-0474 5072600, 621265 2121 Hughes Drive, Suite HMT 820, OH 43606 Phone: 419-843-7800 / Fax: 419-843-3444 Secor Sleep Diagnostic Center, L.L.C.* 7236569, 3709 4428 Secor Road, Suite A, OH 43623 Phone: 419-471-9757 / Fax: 419-471-9778 Sleep Network of, Inc. Dba The Regional Center for Sleep Medicine* 7235526, 6952045 4041 West Avenue, Suite 202, OH 43623 Phone: 419-292-1616 / Fax: 419-472-2193 Hours: M-F 8am-4pm The Clinic*, OH 43623 SANDUSKY COUNTY Bellevue The Bellevue Hospital* 6460185, 7912320 1400 West Main Street Bellevue, OH 44811 Phone: 419-483-4040 / Fax: 419-483-9718 Fremont Memorial Hospital* 6460655, 159289 715 South Taft Avenue Phone: 419-332-7321 / Fax: 419-334-6671 5072600, 812757 1750 South Taft Phone: 419-333-0840 5072600, 159289 715 South Taft Avenue Phone: 419-333-0840 WOOD COUNTY Bowling Green Wood County Hospital 6460205, 159184 950 West Wooster Street Bowling Green, OH 43402 Phone: 419-354-8900 Perrysburg Perrysburg Family Physicians, L.L.C.* 7982653, 4122275 702 Commerce Drive, Suite 160 Perrysburg, OH 43551 Phone: 419-872-7600 / Fax: 419-872-7601 Physician Diagnostic Sleep Technology Specialists LLC* 7754456, 6491100 900 West South Boundary Perrysburg, OH 43551 Phone: 419-872-3660 / Fax: 419-872-3662