| Prohealth Physician Group Llc | |
|
12611 Eckel Junction Rd Perrysburg OH 43551-1304 | |
| (877) 511-9739 | |
| (866) 437-9066 |
| Full Name | Prohealth Physician Group Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 12611 Eckel Junction Rd, Perrysburg, Ohio |
| Authorized Official Name and Position | Ritchie Adams (OWNER/CEO) |
| Authorized Official Contact | 4194917150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prohealth Physician Group Llc 12611 Eckel Junction Rd Perrysburg OH 43551-1304 Ph: (877) 511-9739 | Prohealth Physician Group Llc 12611 Eckel Junction Rd Perrysburg OH 43551-1304 Ph: (877) 511-9739 |
| NPI Number | 1912208729 |
|---|---|
| Provider Enumeration Date | 11/10/2010 |
| Last Update Date | 12/30/2020 |
| Certification Date | 12/30/2020 |
| Medicare PECOS PAC ID | 3577749993 |
|---|---|
| Medicare Enrollment ID | O20110519000839 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912208729 | NPI | - | NPPES |
| Provider Name | Kelly A Shank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922084425 PECOS PAC ID: 3476591355 Enrollment ID: I20050421000254 |
| Provider Name | Melanie Caroline Schell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922148147 PECOS PAC ID: 7113935842 Enrollment ID: I20060322000433 |
| Provider Name | Scott M Galenski |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1376956292 PECOS PAC ID: 5496974693 Enrollment ID: I20140922000751 |
| Provider Name | James Derosa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104033562 PECOS PAC ID: 8921386657 Enrollment ID: I20161031001233 |
| Provider Name | Brittney Goldi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457997637 PECOS PAC ID: 0446685515 Enrollment ID: I20200415000211 |
| Provider Name | Elizabeth Stratmann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942658844 PECOS PAC ID: 6608297429 Enrollment ID: I20200603002523 |
| Provider Name | Janna L Mennetti |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1861061707 PECOS PAC ID: 3678977121 Enrollment ID: I20210805003544 |
| Provider Name | Jeffrey S Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548855901 PECOS PAC ID: 0840696969 Enrollment ID: I20210914003802 |
| Provider Name | Lisa Lynn Greer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528722857 PECOS PAC ID: 8628467776 Enrollment ID: I20211111002366 |
| Provider Name | Dena M Holzemer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396017448 PECOS PAC ID: 6103209010 Enrollment ID: I20220810000912 |
| Provider Name | Alicia Komives |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174262539 PECOS PAC ID: 7113301268 Enrollment ID: I20220908002385 |
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