| Gch Physician Practice | |
|
330 N Seltzer St Crestline OH 44827-1403 | |
| (419) 468-4841 | |
| Not Available |
| Full Name | Gch Physician Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 330 N Seltzer St, Crestline, Ohio |
| Authorized Official Name and Position | Donald Eric Praime (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4194680504 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gch Physician Practice 330 N Seltzer St Crestline OH 44827-1403 Ph: () - | Gch Physician Practice 330 N Seltzer St Crestline OH 44827-1403 Ph: (419) 468-4841 |
| NPI Number | 1790918514 |
|---|---|
| Provider Enumeration Date | 08/27/2009 |
| Last Update Date | 12/18/2014 |
| Medicare PECOS PAC ID | 5496737439 |
|---|---|
| Medicare Enrollment ID | O20121228000295 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790918514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Siraj A Siddiqui, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 216 W Main St, Crestline, OH 44827 Phone: 419-683-8041 | |
Gch Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 N Seltzer St, Crestline, OH 44827 Phone: 419-683-3200 | |
Gch Physician Practices, Seltzer Station Campus Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 385 N. Seltzer Street, Crestline, OH 44827 Phone: 419-468-4841 Fax: 419-468-2381 |