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General NPI Number Information
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NPI Number | 1831295450
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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 | 09/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6024 HOOVER RD SUITE F
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City | GROVE CITY
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State | OH
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Zip | 43123-8133
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Country | US
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Telephone | 614-871-3121
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Fax | 614-871-4401
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 35054838
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License Number State | OH
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