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NPI Code Detail

MEDICARE: HUDSON FAMILY HEALTH CENTER, INC.

MEDICARE: HUDSON FAMILY HEALTH CENTER, 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

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1M1005165OTHEROHMEDAVANT CLEARING HOUSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144414269
Entity Type Code : Organization
Provider Name (Legal Business Name) : HUDSON FAMILY HEALTH CENTER, INC.
Provider Business Mailing Address
First Line : 5111 DARROW RD
Second Line :
City : HUDSON
State : OH
Zip : 44236-4003
Country : US
Telephone Number : 330-655-2668
Fax Number : 330-342-5608
Provider Business Practice Location Address
First Line : 5111 DARROW RD
Second Line :
City : HUDSON
State : OH
Zip : 44236-4003
Country : US
Telephone Number : 330-655-2668
Fax Number : 330-342-5608
Authorized Official
Title or Position : PRESIDENT
Name : DR. JEANETTE ANN MOLESKI
Credential : D.O.
Telephone Number : 330-655-2668
Provider Enumeration Date : 08/31/2007
Last Update Date : 08/31/2007

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Directions to “HUDSON FAMILY HEALTH CENTER, INC. ” Practice Location

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