Healthsource Of Ohio, Inc. | |
6131 Campus Ln Cincinnati OH 45230-1601 | |
(513) 732-5088 | |
(513) 231-2620 |
Full Name | Healthsource Of Ohio, Inc. |
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Speciality | Clinic/Center |
Location | 6131 Campus Ln, Cincinnati, Ohio |
Authorized Official Name and Position | Joseph W Prather Ii (CEO) |
Authorized Official Contact | 5137074041 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Healthsource Of Ohio, Inc. 424 Wards Corner Rd Ste 200 Loveland OH 45140-6966 Ph: (513) 707-4041 | Healthsource Of Ohio, Inc. 6131 Campus Ln Cincinnati OH 45230-1601 Ph: (513) 732-5088 |
NPI Number | 1023358892 |
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Provider Enumeration Date | 02/15/2013 |
Last Update Date | 09/18/2024 |
Medicare PECOS PAC ID | 2264328749 |
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Medicare Enrollment ID | O20130606000001 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023358892 | NPI | - | NPPES |
0087606 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Ohio) | Primary |
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