| Primesource Healthcare Of Ohio, Inc | |
|
4449 Easton Way Floor 2 Columbus OH 43219-6093 | |
| (800) 317-0711 | |
| (877) 821-6402 |
| Full Name | Primesource Healthcare Of Ohio, Inc |
|---|---|
| Speciality | Dentist |
| Location | 4449 Easton Way, Columbus, Ohio |
| Authorized Official Name and Position | David Fleming (PRESIDENT & CEO) |
| Authorized Official Contact | 8472678200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primesource Healthcare Of Ohio, Inc 2100 East Lake Cook Road Suite 1100 Buffalo Grove IL 60089-1815 Ph: (847) 267-8200 | Primesource Healthcare Of Ohio, Inc 4449 Easton Way Floor 2 Columbus OH 43219-6093 Ph: (800) 317-0711 |
| NPI Number | 1235304775 |
|---|---|
| Provider Enumeration Date | 04/25/2008 |
| Last Update Date | 10/12/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235304775 | NPI | - | NPPES |
| 2719062 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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