| Patterson Park Health Center | |
|
1074 Patterson Rd Kettering OH 45420-1522 | |
| (937) 258-6330 | |
| Not Available |
| Full Name | Patterson Park Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1074 Patterson Rd, Kettering, Ohio |
| Authorized Official Name and Position | Gregory Hopkins (CEO) |
| Authorized Official Contact | 9375869733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patterson Park Health Center 1323 W 3rd St Dayton OH 45402-6714 Ph: (937) 586-9733 | Patterson Park Health Center 1074 Patterson Rd Kettering OH 45420-1522 Ph: (937) 258-6330 |
| NPI Number | 1134468549 |
|---|---|
| Provider Enumeration Date | 02/05/2013 |
| Last Update Date | 12/21/2021 |
| Medicare PECOS PAC ID | 7012094386 |
|---|---|
| Medicare Enrollment ID | O20130426000396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134468549 | NPI | - | NPPES |
| 0085678 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 93.224 (Ohio) | Primary |
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