Healthcare Provider Details

I. General information

NPI: 1720018971
Provider Name (Legal Business Name): PIKE HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DAWN LANE
WAVERLY OH
45690-9138
US

IV. Provider business mailing address

272 HOSPITAL RD SUITE 3
CHILLICOTHEE OH
45601-9031
US

V. Phone/Fax

Practice location:
  • Phone: 740-947-2186
  • Fax: 740-947-6538
Mailing address:
  • Phone: 740-779-4460
  • Fax: 740-779-4257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1299
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1299
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY GARDNER CRAFT
Title or Position: VICE PRESIDENT FOR SYSTEM FINANCE
Credential:
Phone: 740-779-4481