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14590 State Route 93 Jackson OH 45640-8977 | |
(740) 286-2826 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 14590 State Route 93, Jackson, Ohio |
Authorized Official Name and Position | Keith Eric Pitts (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 7402892371 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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941 Market St Piketon OH 45661-9757 Ph: (740) 289-2371 | 14590 State Route 93 Jackson OH 45640-8977 Ph: (740) 286-2826 |
NPI Number | 1023100955 |
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Provider Enumeration Date | 09/28/2006 |
Last Update Date | 06/09/2020 |
Medicare PECOS PAC ID | 3173432762 |
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Medicare Enrollment ID | O20101201000508 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023100955 | NPI | - | NPPES |
0829465 | Medicaid | OH | |
2616440 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Community Action Committee Of Pike County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14590 St Rt 93, Family Health Center Jackson, Jackson, OH 45640 Phone: 740-286-2826 | |
Hopewell Health Centers Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 502 Mccarty Ln, Jackson, OH 45640 Phone: 740-286-5245 Fax: 740-286-7642 | |
Oak Hill Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 Burlington Rd, Jackson, OH 45640 Phone: 740-286-3034 Fax: 740-286-6424 |