| Healthsource Of Ohio, Inc. | |
|
100 River Valley Blvd New Richmond OH 45157-8566 | |
| (513) 553-3114 | |
| (513) 553-1032 |
| Full Name | Healthsource Of Ohio, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 River Valley Blvd, New Richmond, Ohio |
| Authorized Official Name and Position | Joseph W Prather Ii (CEO) |
| Authorized Official Contact | 5137074041 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthsource Of Ohio, Inc. 424 Wards Corner Rd Ste 200 Loveland OH 45140-6966 Ph: (513) 707-4041 | Healthsource Of Ohio, Inc. 100 River Valley Blvd New Richmond OH 45157-8566 Ph: (513) 553-3114 |
| NPI Number | 1942242284 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 09/18/2024 |
| Medicare PECOS PAC ID | 2264328749 |
|---|---|
| Medicare Enrollment ID | O20070423000523 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942242284 | NPI | - | NPPES |
| 0824200 | Medicaid | OH | |
| CH7473 | Other | OH | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Healthsource Of Ohio, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 River Valley Blvd, New Richmond, OH 45157 Phone: 513-553-3114 Fax: 513-553-1032 |