| Southeast, Inc. | |
|
68353 Bannock Rd Saint Clairsville OH 43950-9736 | |
| (740) 695-9344 | |
| (740) 695-7787 |
| Full Name | Southeast, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 68353 Bannock Rd, Saint Clairsville, Ohio |
| Authorized Official Name and Position | John Bell (CFO) |
| Authorized Official Contact | 6142250980 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast, Inc. 16 W Long St Columbus OH 43215-2815 Ph: (614) 225-0980 | Southeast, Inc. 68353 Bannock Rd Saint Clairsville OH 43950-9736 Ph: (740) 695-9344 |
| NPI Number | 1164800165 |
|---|---|
| Provider Enumeration Date | 05/11/2015 |
| Last Update Date | 12/27/2019 |
| Medicare PECOS PAC ID | 8426014853 |
|---|---|
| Medicare Enrollment ID | O20150817000599 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164800165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | H80CS22681 (Ohio) | Primary |
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