HEALTHSOURCE OF OHIO INC. NPI 1841624350

NPI Information

NPI: 1841624350
Provider Name: HEALTHSOURCE OF OHIO, INC.

Doing Business As: HEALTHSOURCE: LEBANON

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1231 COLUMBUS AVE
UNIT A1
LEBANON, OH
ZIP 45036
Phone: (513) 696-4495
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HEALTHSOURCE OF OHIO, INC. is a federally qualified health center (fqhc) clinic center in Lebanon, OH. HEALTHSOURCE OF OHIO, INC. NPI is 1841624350. The provider is registered as an organization entity type.
The provider Is Doing Business As Healthsource: Lebanon.

The provider's business location address is:

1231 COLUMBUS AVE
UNIT A1
LEBANON, OH
ZIP 45036-195
Phone: (513) 696-4495
Fax: (513) 228-1236

The provider's authorized official is Kimberly Patton .
The authorized official title is Ceo/president and has the following contact phone number (513) 576-7700.

The enumeration date for this NPI number is 9/3/2013 and was last updated on 4/30/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0103505	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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