| Kettering Health Primary Care, A Service Of Kettering Health Greene Me | |
|
888 Dayton St Ste 200 Yellow Springs OH 45387-1777 | |
| (937) 767-7291 | |
| (937) 737-1302 |
| Full Name | Kettering Health Primary Care, A Service Of Kettering Health Greene Me |
|---|---|
| Speciality | Clinic/Center |
| Location | 888 Dayton St, Yellow Springs, Ohio |
| Authorized Official Name and Position | Timothy Ko (NETWORK CFO) |
| Authorized Official Contact | 9373958995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kettering Health Primary Care, A Service Of Kettering Health Greene Me 2110 Leiter Rd Miamisburg OH 45342-3598 Ph: () - | Kettering Health Primary Care, A Service Of Kettering Health Greene Me 888 Dayton St Ste 200 Yellow Springs OH 45387-1777 Ph: (937) 767-7291 |
| NPI Number | 1831503853 |
|---|---|
| Provider Enumeration Date | 06/18/2014 |
| Last Update Date | 06/07/2023 |
| Medicare PECOS PAC ID | 3971406539 |
|---|---|
| Medicare Enrollment ID | O20141020000634 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831503853 | NPI | - | NPPES |
| 0144766 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Ohio) | Primary |
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