| Middletown Community Health Consortium | |
|
1036 S Verity Pkwy Middletown OH 45044-5513 | |
| (513) 454-1460 | |
| (513) 454-1484 |
| Full Name | Middletown Community Health Consortium |
|---|---|
| Speciality | Clinic/Center |
| Location | 1036 S Verity Pkwy, Middletown, Ohio |
| Authorized Official Name and Position | Ryan G Randall (CFO) |
| Authorized Official Contact | 5134541460 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Middletown Community Health Consortium Po Box 837 Hamilton OH 45012-0837 Ph: () - | Middletown Community Health Consortium 1036 S Verity Pkwy Middletown OH 45044-5513 Ph: (513) 454-1460 |
| NPI Number | 1700821386 |
|---|---|
| Provider Enumeration Date | 06/18/2006 |
| Last Update Date | 11/03/2023 |
| Medicare PECOS PAC ID | 7810884780 |
|---|---|
| Medicare Enrollment ID | O20051219000815 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700821386 | NPI | - | NPPES |
| 2597837 | Medicaid | OH | |
| FWHCLA200 | Other | FQHC NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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