MEDICARE: HOPE 4 U CLINIC LLC

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
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1598252348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE 4 U CLINIC LLC

Provider Business Mailing Address
First Line	:	2530 SUTTON RD
Second Line	:
City	:	YELLOW SPRINGS
State	:	OH
Zip	:	45387-8744
Country	:	US
Telephone Number	:	937-660-6776
Fax Number	:

Provider Business Practice Location Address
First Line	:	2530 SUTTON RD
Second Line	:
City	:	YELLOW SPRINGS
State	:	OH
Zip	:	45387-8744
Country	:	US
Telephone Number	:	937-416-9155
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATHLEEN GLOVER
Credential	:	MD
Telephone Number	:	937-660-6776

Provider Enumeration Date	:	04/17/2018
Last Update Date	:	03/29/2024

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