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General NPI Number Information
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NPI Number | 1124504378
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Entity Type | Organization
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Legal Business Name | BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.
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Dates
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Enumeration Date | 07/11/2018
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 601 N BREIEL BLVD STE B
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City | MIDDLETOWN
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State | OH
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Zip | 45042
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Country | US
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Telephone | 513-454-1111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 837
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City | HAMILTON
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State | OH
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Zip | 45012-0837
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Country | US
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Telephone | 515-454-1468
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | RYAN G. RANDALL
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Credential |
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Telephone | 513-454-1468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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