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NPI Code Detail

MEDICARE: PRIME FAMILY HEALTH CENTER OF DAYTON LLC

MEDICARE: PRIME FAMILY HEALTH CENTER OF DAYTON 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
1111N00000XChiropractor1982OH
2207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1801188842
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIME FAMILY HEALTH CENTER OF DAYTON LLC
Provider Business Mailing Address
First Line : 8120 GARNET DR
Second Line :
City : DAYTON
State : OH
Zip : 45458-2141
Country : US
Telephone Number : 937-291-2511
Fax Number : 937-291-2523
Provider Business Practice Location Address
First Line : 8120 GARNET DR
Second Line :
City : DAYTON
State : OH
Zip : 45458-2141
Country : US
Telephone Number : 937-291-2511
Fax Number : 937-291-2523
Authorized Official
Title or Position : OWNER
Name : DR. ROBERT GRANT GOODWIN
Credential : D.C.
Telephone Number : 937-291-2511
Provider Enumeration Date : 05/10/2011
Last Update Date : 05/10/2011

Similar Medicare Providers

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Practice Location Address:
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Directions to “PRIME FAMILY HEALTH CENTER OF DAYTON LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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