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NPI Code Detail

MEDICARE: BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.

MEDICARE: BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1467825158
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.
Provider Business Mailing Address
First Line : PO BOX 837
Second Line :
City : HAMILTON
State : OH
Zip : 45012-0837
Country : US
Telephone Number : 513-454-1460
Fax Number :
Provider Business Practice Location Address
First Line : 250 N FAIR AVE
Second Line :
City : HAMILTON
State : OH
Zip : 45011-4222
Country : US
Telephone Number : 513-454-1460
Fax Number :
Authorized Official
Title or Position : CFO
Name : RYAN RANDALL
Credential :
Telephone Number : 513-454-1468
Provider Enumeration Date : 11/04/2015
Last Update Date : 11/03/2023

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