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NPI Code Detail

MEDICARE: HEALTH PROFESSIONALS OF HOLMEST COUNTY, INC.

MEDICARE: HEALTH PROFESSIONALS OF HOLMEST COUNTY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1013398874
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTH PROFESSIONALS OF HOLMEST COUNTY, INC.
Provider Business Mailing Address
First Line : 981 WOOSTER RD
Second Line :
City : MILLERSBURG
State : OH
Zip : 44654-1536
Country : US
Telephone Number : 330-674-0015
Fax Number : 330-674-9314
Provider Business Practice Location Address
First Line : 1261 WOOSTER RD STE 200
Second Line :
City : MILLERSBURG
State : OH
Zip : 44654-1570
Country : US
Telephone Number : 330-674-3000
Fax Number :
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : JASON JUSTUS
Credential :
Telephone Number : 330-674-1015
Provider Enumeration Date : 06/17/2015
Last Update Date : 08/01/2023

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