MEDICARE: BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, 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
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1073322616
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.

Provider Business Mailing Address
First Line	:	PO BOX 837
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45012-0837
Country	:	US
Telephone Number	:	513-820-0432
Fax Number	:

Provider Business Practice Location Address
First Line	:	3145 HAMILTON MASON RD STE 202
Second Line	:
City	:	FAIRFIELD TOWNSHIP
State	:	OH
Zip	:	45011-8556
Country	:	US
Telephone Number	:	513-454-1111
Fax Number	:	513-737-1592

Authorized Official
Title or Position	:	CFO
Name	:	RYAN RANDALL
Credential	:
Telephone Number	:	513-454-1468

Provider Enumeration Date	:	01/07/2025
Last Update Date	:	01/07/2025

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