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110 North Walnut Street Gnadenhutten OH 44629 | |
(740) 254-9443 | |
(740) 254-9445 |
Full Name | |
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Speciality | Clinic/Center |
Location | 110 North Walnut Street, Gnadenhutten, Ohio |
Authorized Official Name and Position | Robin Brown (PRACTICE ADMINISTRATOR) |
Authorized Official Contact | 7409227450 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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819 N 1st St Dennison OH 44621-1003 Ph: (740) 922-0000 | 110 North Walnut Street Gnadenhutten OH 44629 Ph: (740) 254-9443 |
NPI Number | 1104265792 |
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Provider Enumeration Date | 06/18/2013 |
Last Update Date | 06/18/2013 |
Medicare PECOS PAC ID | 6204004534 |
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Medicare Enrollment ID | O20131108001219 |
Identifier | Type | State | Issuer |
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1104265792 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 2001194 (Ohio) | Primary |