Healthcare Provider Details

I. General information

NPI: 1174914683
Provider Name (Legal Business Name): CLINCARE INTERNATIONAL CENTER LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2015
Last Update Date: 10/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2416 ESQUIRE DR SUITE B
BEAVERCREEK OH
45431-2573
US

IV. Provider business mailing address

2416 ESQUIRE DRIVE SUITE B
BEAVERCREEK OH
45431-2573
US

V. Phone/Fax

Practice location:
  • Phone: 937-429-2422
  • Fax: 937-352-4111
Mailing address:
  • Phone: 937-429-2422
  • Fax: 937-352-4111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC.3089
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35.086273
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.125600
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.075882
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.100278
License Number State
# 6
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.087069
License Number StateOH
# 7
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35.046160
License Number State
# 8
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34.007858
License Number StateOH
# 9
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35.075704
License Number StateOH
# 10
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35.126026
License Number StateOH
# 11
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. RAKESH ARORA
Title or Position: DIRECTOR
Credential: MS COMPUTER SCIENCE
Phone: 937-429-2422