Lower Lights Christian Health Center Inc | |
69 S Terrace Ave Newark OH 43055 | |
(614) 274-1455 | |
(614) 274-1433 |
Full Name | Lower Lights Christian Health Center Inc |
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Speciality | Clinic/Center |
Location | 69 S Terrace Ave, Newark, Ohio |
Authorized Official Name and Position | Shelly Maurey (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 6142741455 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lower Lights Christian Health Center Inc 1160 W Broad St Columbus OH 43222-1352 Ph: (614) 274-1455 | Lower Lights Christian Health Center Inc 69 S Terrace Ave Newark OH 43055 Ph: (614) 274-1455 |
NPI Number | 1144892472 |
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Provider Enumeration Date | 07/15/2021 |
Last Update Date | 06/08/2023 |
Medicare PECOS PAC ID | 5193794188 |
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Medicare Enrollment ID | O20210915002687 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144892472 | NPI | - | NPPES |
0477562 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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