Healthcare Provider Details

I. General information

NPI: 1316727415
Provider Name (Legal Business Name): HOPEWELL HEALTH CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2023
Last Update Date: 10/06/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51-55 W STATE ST. OFFICE #218
ATHENS OH
45701-2503
US

IV. Provider business mailing address

PO BOX 188
CHILLICOTHEE OH
45601-0188
US

V. Phone/Fax

Practice location:
  • Phone: 740-541-4135
  • Fax:
Mailing address:
  • Phone: 740-773-4366
  • Fax: 740-773-4426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MARK BRIDENBAUGH
Title or Position: CEO
Credential:
Phone: 740-773-4366