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1018 Ralston Ave Defiance OH 43512-5312 | |
(419) 567-2138 | |
(419) 225-8878 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1018 Ralston Ave, Defiance, Ohio |
Authorized Official Name and Position | Janis L. Sunderhaus (CEO) |
Authorized Official Contact | 4192213072 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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329 N West St Lima OH 45801-4332 Ph: (419) 221-3072 | 1018 Ralston Ave Defiance OH 43512-5312 Ph: (419) 567-2138 |
NPI Number | 1780929729 |
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Provider Enumeration Date | 12/03/2012 |
Last Update Date | 02/02/2024 |
Medicare PECOS PAC ID | 9436139987 |
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Medicare Enrollment ID | O20130125000326 |
Identifier | Type | State | Issuer |
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1780929729 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Everside Health, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 25568 Elliott Rd, Defiance, OH 43512 Phone: 419-782-2147 Fax: 419-782-2157 | |
Robert E Barnett Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1105 Ralston Ave, Defiance, OH 43512 Phone: 419-782-3111 Fax: 419-782-3118 | |