| Paulding Medical Center, Inc. | |
|
11550 State Route 500 Paulding OH 45879-9173 | |
| (419) 399-2630 | |
| (419) 399-3039 |
| Full Name | Paulding Medical Center, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 11550 State Route 500, Paulding, Ohio |
| Authorized Official Name and Position | Frederic Charles Hendrickson (OWNER) |
| Authorized Official Contact | 4193992630 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paulding Medical Center, Inc. 11550 State Route 500 Paulding OH 45879-9173 Ph: (419) 399-2630 | Paulding Medical Center, Inc. 11550 State Route 500 Paulding OH 45879-9173 Ph: (419) 399-2630 |
| NPI Number | 1619298924 |
|---|---|
| Provider Enumeration Date | 06/21/2010 |
| Last Update Date | 06/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619298924 | NPI | - | NPPES |
| 0853170 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 34-005455 (Ohio) | Primary |
Pch Physician Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1032 W. Wayne St, Paulding, OH 45879 Phone: 419-399-1104 Fax: 419-399-5560 |