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General NPI Number Information
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NPI Number | 1497190771
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Entity Type | Organization
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Legal Business Name | FIVE RIVERS HEALTH CENTERS
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Dates
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Enumeration Date | 05/01/2013
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Last Update Date | 05/13/2022
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Provider Practice Location Address
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Address Line | 721 MIAMI CHAPEL RD
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City | DAYTON
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State | OH
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Zip | 45417-4650
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Country | US
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Telephone | 937-329-9786
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Fax | 937-432-9780
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Provider Business Mailing Address
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Address Line | 721 MIAMI CHAPEL RD
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City | DAYTON
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State | OH
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Zip | 45417-4650
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Country | US
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Telephone | 937-281-6800
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Fax | 937-432-9780
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Authorized Official
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Title or Position | CEO
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Name | GINA MCFARLANE-EL
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Credential |
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Telephone | 937-281-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 022316850
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License Number State | OH
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