Healthcare Provider Details

I. General information

NPI: 1457869489
Provider Name (Legal Business Name): FAMILY PRACTICE WESTCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2018
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 FARM BANK WAY
GROVE CITY OH
43123-1974
US

IV. Provider business mailing address

3421 FARM BANK WAY
GROVE CITY OH
43123-1974
US

V. Phone/Fax

Practice location:
  • Phone: 614-878-7285
  • Fax: 614-878-1703
Mailing address:
  • Phone: 614-878-7285
  • Fax: 614-878-1703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateOH

VIII. Authorized Official

Name: SARAH PERLMAN
Title or Position: OWNER/ CNP
Credential:
Phone: 614-878-7285