| Healthsource Of Ohio, Inc. | |
|
6131 Campus Ln Cincinnati OH 45230-1601 | |
| (513) 732-5088 | |
| (513) 231-2620 |
| Full Name | Healthsource Of Ohio, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 6131 Campus Ln, Cincinnati, Ohio |
| Authorized Official Name and Position | Kimberly Patton (CEO/PRESIDENT) |
| Authorized Official Contact | 5135767700 |
| 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. 6131 Campus Ln Cincinnati OH 45230-1601 Ph: (513) 732-5088 |
| NPI Number | 1023358892 |
|---|---|
| Provider Enumeration Date | 02/15/2013 |
| Last Update Date | 09/10/2020 |
| Medicare PECOS PAC ID | 2264328749 |
|---|---|
| Medicare Enrollment ID | O20130606000001 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023358892 | NPI | - | NPPES |
| 0087606 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Ohio) | Primary |
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