Healthridge Medical Center Inc | |
315 Struthers Liberty Rd Campbell OH 44405-1949 | |
(330) 750-1333 | |
(330) 750-0203 |
Full Name | Healthridge Medical Center Inc |
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Speciality | Family Medicine |
Location | 315 Struthers Liberty Rd, Campbell, Ohio |
Authorized Official Name and Position | Vicki Lynn Miller (PRACTICE ADMINISTRATOR) |
Authorized Official Contact | 3307501333 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Healthridge Medical Center Inc 315 Struthers Liberty Rd Campbell OH 44405-1949 Ph: (330) 750-1333 | Healthridge Medical Center Inc 315 Struthers Liberty Rd Campbell OH 44405-1949 Ph: (330) 750-1333 |
NPI Number | 1497717664 |
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Provider Enumeration Date | 04/04/2006 |
Last Update Date | 12/09/2009 |
Medicare PECOS PAC ID | 7416908678 |
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Medicare Enrollment ID | O20050204000136 |
Identifier | Type | State | Issuer |
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1497717664 | NPI | - | NPPES |
Provider Name | Douglas Dalziel Lewis |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1629037239 PECOS PAC ID: 9739168808 Enrollment ID: I20051205000207 |
Provider Name | Michael Shultz |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1649261868 PECOS PAC ID: 2961453121 Enrollment ID: I20100322000740 |
Provider Name | Jeremiah Noggle |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669755005 PECOS PAC ID: 3971741604 Enrollment ID: I20150406000219 |
Provider Name | Nikki Theodora Tacsik |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700548187 PECOS PAC ID: 0345639894 Enrollment ID: I20211123000281 |