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407 Oak Street Elmwood OH 45219-2504 | |
| (513) 242-1033 | |
| (513) 242-1539 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 407 Oak Street, Elmwood, Ohio |
| Authorized Official Name and Position | Miriam Crenshaw (CEO) |
| Authorized Official Contact | 5132421033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5275 Winneste Ave Cincinnati OH 45232-1130 Ph: (513) 242-1033 | 407 Oak Street Elmwood OH 45219-2504 Ph: (513) 242-1033 |
| NPI Number | 1851560346 |
|---|---|
| Provider Enumeration Date | 02/28/2008 |
| Last Update Date | 07/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851560346 | NPI | - | NPPES |
| 2856860 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |