Healthcare Provider Details

I. General information

NPI: 1730011453
Provider Name (Legal Business Name): BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3775 SHROYER RD
KETTERING OH
45429-2735
US

IV. Provider business mailing address

PO BOX 837
HAMILTON OH
45012-0837
US

V. Phone/Fax

Practice location:
  • Phone: 513-454-1111
  • Fax: 513-737-1592
Mailing address:
  • Phone: 513-820-0432
  • Fax:

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: STEPHEN JOSEPH ROLLER
Title or Position: CEO
Credential:
Phone: 513-454-1467