| Thornville Family Medical Center Inc | |
|
41 Foster Dr Thornville OH 43076 | |
| (740) 246-6361 | |
| (740) 246-4722 |
| Full Name | Thornville Family Medical Center Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 41 Foster Dr, Thornville, Ohio |
| Authorized Official Name and Position | Larry I Cowan (PRESIDENT) |
| Authorized Official Contact | 7402466361 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thornville Family Medical Center Inc Po Box 550 Lancaster OH 43130-0550 Ph: (740) 687-5164 | Thornville Family Medical Center Inc 41 Foster Dr Thornville OH 43076 Ph: (740) 246-6361 |
| NPI Number | 1447226931 |
|---|---|
| Provider Enumeration Date | 02/24/2006 |
| Last Update Date | 03/16/2010 |
| Medicare PECOS PAC ID | 6608897426 |
|---|---|
| Medicare Enrollment ID | O20100315000450 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447226931 | NPI | - | NPPES |
| 0511413 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Shelby K Raiser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396725271 PECOS PAC ID: 0648291468 Enrollment ID: I20051208000393 |
| Provider Name | Larry I Cowan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023002011 PECOS PAC ID: 3870490022 Enrollment ID: I20100315000408 |
| Provider Name | Melissa J Koppelman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790225423 PECOS PAC ID: 4183997877 Enrollment ID: I20200605001316 |