| Midwest Psychiatric Center, Inc. | |
|
1545 S Breiel Blvd Middletown OH 45044-6703 | |
| (513) 217-5221 | |
| (513) 217-6221 |
| Full Name | Midwest Psychiatric Center, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1545 S Breiel Blvd, Middletown, Ohio |
| Authorized Official Name and Position | Rakeshkumar M Kaneria (PRESIDENT) |
| Authorized Official Contact | 5132175221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Psychiatric Center, Inc. Po Box 635924 Cincinnati OH 45263-5924 Ph: (513) 421-3504 | Midwest Psychiatric Center, Inc. 1545 S Breiel Blvd Middletown OH 45044-6703 Ph: (513) 217-5221 |
| NPI Number | 1649467119 |
|---|---|
| Provider Enumeration Date | 09/28/2007 |
| Last Update Date | 03/19/2009 |
| Medicare PECOS PAC ID | 0143301945 |
|---|---|
| Medicare Enrollment ID | O20080118000020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649467119 | NPI | - | NPPES |
| 293747 | Other | OH | AMERIGROUP |
| 603986997-002 | Other | OH | MMOH |
| 2804013 | Medicaid | OH | |
| 603986997-00 | Other | OH | BWC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 35083440 (Ohio) | Primary |
| Provider Name | Rakesh M Kaneria |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740347566 PECOS PAC ID: 2567436637 Enrollment ID: I20040824000742 |
| Provider Name | Tammy Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407159338 PECOS PAC ID: 1052685781 Enrollment ID: I20170919004026 |
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