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500 S 5th St Ste 202 Williamsburg OH 45176-1017 | |
(513) 732-5086 | |
(513) 436-0470 |
Full Name | |
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Speciality | Clinic/Center |
Location | 500 S 5th St Ste 202, Williamsburg, 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 |
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424 Wards Corner Rd Ste 200 Loveland OH 45140-6966 Ph: (513) 576-7700 | 500 S 5th St Ste 202 Williamsburg OH 45176-1017 Ph: (513) 732-5086 |
NPI Number | 1841812393 |
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Provider Enumeration Date | 05/07/2020 |
Last Update Date | 09/18/2024 |
Medicare PECOS PAC ID | 2264328749 |
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Medicare Enrollment ID | O20200827001379 |
Identifier | Type | State | Issuer |
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1841812393 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Eastside Internal Medicine-geriatrics, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1001 W Main St, Williamsburg, OH 45176 Phone: 513-724-2226 Fax: 513-724-5248 |