| Beavercreek Family Health Center Llc | |
|
2365 Lakeview Dr Suite C Beavercreek OH 45431-4600 | |
| (937) 477-3460 | |
| Not Available |
| Full Name | Beavercreek Family Health Center Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2365 Lakeview Dr, Beavercreek, Ohio |
| Authorized Official Name and Position | Philip S Whitecar (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9374772460 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beavercreek Family Health Center Llc 2365 Lakeview Dr Suite C Beavercreek OH 45431-4600 Ph: (937) 477-3460 | Beavercreek Family Health Center Llc 2365 Lakeview Dr Suite C Beavercreek OH 45431-4600 Ph: (937) 477-3460 |
| NPI Number | 1710314901 |
|---|---|
| Provider Enumeration Date | 10/02/2013 |
| Last Update Date | 02/05/2014 |
| Medicare PECOS PAC ID | 4284862905 |
|---|---|
| Medicare Enrollment ID | O20131231001953 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710314901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Philip S Whitecar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174504617 PECOS PAC ID: 9638199623 Enrollment ID: I20051206000494 |
| Provider Name | Mary E Rodes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215142260 PECOS PAC ID: 2668573353 Enrollment ID: I20070725000232 |
| Provider Name | Sarah Khavari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295942621 PECOS PAC ID: 1658445903 Enrollment ID: I20080804000661 |
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