Healthcare Provider Details

I. General information

NPI: 1902855026
Provider Name (Legal Business Name): FAMILY HEALTH SERVICES OF EAST CENTRAL OHIO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 04/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MCMILLEN DR
NEWARK OH
43055
US

IV. Provider business mailing address

100 MCMILLEN DR
NEWARK OH
43055
US

V. Phone/Fax

Practice location:
  • Phone: 740-344-9291
  • Fax: 740-344-1040
Mailing address:
  • Phone: 740-344-9291
  • Fax: 740-344-1040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number02-0272800
License Number StateOH

VIII. Authorized Official

Name: KIMBERLY MASON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 740-344-9291