| |
101 S Main St Centerville OH 45458-2369 | |
(937) 291-4424 | |
(937) 291-4428 |
Full Name | |
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Speciality | Family Medicine |
Location | 101 S Main St, Centerville, Ohio |
Authorized Official Name and Position | Kenneth Prunier (PRESIDENT/CEO) |
Authorized Official Contact | 9372088213 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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101 S Main St Centerville OH 45458-2369 Ph: (937) 291-4424 | 101 S Main St Centerville OH 45458-2369 Ph: (937) 291-4424 |
NPI Number | 1740233212 |
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Provider Enumeration Date | 05/18/2006 |
Last Update Date | 11/06/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740233212 | NPI | - | NPPES |
2546703 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Pioneer Health Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9223 Great Lakes Cir, Centerville, OH 45458 Phone: 937-912-9428 | |
Edgar Santillan Md Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2400 Miami Valley Dr, Centerville, OH 45459 Phone: 937-556-4324 Fax: 937-439-3786 | |
Sesslar Family Medical Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6627 Centerville Business Pkwy, Centerville, OH 45459 Phone: 937-312-9212 Fax: 937-312-0742 |