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General NPI Number Information
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NPI Number | 1194822536
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Entity Type | Organization
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Legal Business Name | PICKAWAY HEALTH SERVICES
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18360 LAUREL STREET
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City | LAURELVILLE
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State | OH
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Zip | 43135
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Country | US
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Telephone | 740-332-3332
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Fax | 740-332-1212
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Provider Business Mailing Address
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Address Line | 617 LANCASTER PIKE SUITE C
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City | CIRCLEVILLE
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State | OH
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Zip | 43113-8826
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Country | US
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Telephone | 740-420-8078
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Fax | 740-477-3594
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | WENDY C ELLIOTT
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Credential |
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Telephone | 740-420-8078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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