| Healthsource: Goshen | |
|
6694 Goshen Rd Ste 324 Goshen OH 45122-9273 | |
| (513) 592-3690 | |
| (513) 592-3708 |
| Full Name | Healthsource: Goshen |
|---|---|
| Speciality | Clinic/Center |
| Location | 6694 Goshen Rd Ste 324, Goshen, 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: Goshen 424 Wards Corner Rd Ste 200 Loveland OH 45140-6966 Ph: (513) 576-7700 | Healthsource: Goshen 6694 Goshen Rd Ste 324 Goshen OH 45122-9273 Ph: (513) 592-3690 |
| NPI Number | 1528796786 |
|---|---|
| Provider Enumeration Date | 08/15/2022 |
| Last Update Date | 09/18/2024 |
| Medicare PECOS PAC ID | 2264328749 |
|---|---|
| Medicare Enrollment ID | O20230522002390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528796786 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mary A Lee Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6746 Dick Flynn Blvd, Goshen, OH 45122 Phone: 513-722-2603 Fax: 513-722-3423 | |
Healthsource Goshen Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6694 Goshen Rd Ste 324, Goshen, OH 45122 Phone: 513-592-3690 Fax: 513-923-3708 |