| Rocking Horse Center | |
|
212 N Main St London OH 43140-1115 | |
| (740) 845-7286 | |
| (740) 845-7499 |
| Full Name | Rocking Horse Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 212 N Main St, London, Ohio |
| Authorized Official Name and Position | Shonda Wallace (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 9373241111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rocking Horse Center 651 S Limestone St Springfield OH 45505-1965 Ph: (937) 324-1111 | Rocking Horse Center 212 N Main St London OH 43140-1115 Ph: (740) 845-7286 |
| NPI Number | 1770964850 |
|---|---|
| Provider Enumeration Date | 06/15/2015 |
| Last Update Date | 12/11/2020 |
| Medicare PECOS PAC ID | 4789653890 |
|---|---|
| Medicare Enrollment ID | O20150825002743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770964850 | NPI | - | NPPES |
| 0146643 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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