| |
930 9th Ave Middletown OH 45044-5530 | |
(513) 454-1111 | |
(513) 737-1592 |
Full Name | |
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Speciality | Clinic/Center |
Location | 930 9th Ave, Middletown, Ohio |
Authorized Official Name and Position | Ryan Randall (CFO) |
Authorized Official Contact | 5134541468 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 837 Hamilton OH 45012-0837 Ph: (513) 869-4917 | 930 9th Ave Middletown OH 45044-5530 Ph: (513) 454-1111 |
NPI Number | 1528828696 |
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Provider Enumeration Date | 03/19/2024 |
Last Update Date | 02/06/2025 |
Medicare PECOS PAC ID | 7810884780 |
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Medicare Enrollment ID | O20240710000789 |
Identifier | Type | State | Issuer |
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1528828696 | NPI | - | NPPES |
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