Healthcare Provider Details

I. General information

NPI: 1457304305
Provider Name (Legal Business Name): MVHE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8638 OLD TROY PIKE SUITE 103
HUBER HEIGHTS OH
45424-1051
US

IV. Provider business mailing address

8638 OLD TROY PIKE SUITE 103
HUBER HEIGHTS OH
45424-1051
US

V. Phone/Fax

Practice location:
  • Phone: 937-233-5574
  • Fax: 937-233-7313
Mailing address:
  • Phone: 937-233-5574
  • Fax: 937-233-7313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KENNETH PRUNIER
Title or Position: CEO/PRESIDENT
Credential:
Phone: 937-208-8213