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NPI Code Detail

MEDICARE: HEALTH PROFESSIONALS OF HOLMES COUNTY, INC

MEDICARE: HEALTH PROFESSIONALS OF HOLMES 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
1174400000XSpecialist

Other Identifiers

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

General Provider Information

NPI Number : 1174054704
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTH PROFESSIONALS OF HOLMES COUNTY, INC
Provider Business Mailing Address
First Line : 981 WOOSTER RD
Second Line :
City : MILLERSBURG
State : OH
Zip : 44654-1536
Country : US
Telephone Number : 330-893-1318
Fax Number : 330-763-2063
Provider Business Practice Location Address
First Line : 1261 WOOSTER RD STE 230
Second Line :
City : MILLERSBURG
State : OH
Zip : 44654-1570
Country : US
Telephone Number : 330-893-1318
Fax Number : 330-763-2063
Authorized Official
Title or Position : COO
Name : JASON JUSTUS
Credential :
Telephone Number : 330-674-1584
Provider Enumeration Date : 03/24/2017
Last Update Date : 03/28/2019

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1902352065 — HEALTH PROFESSIONALS OF HOLMES COUNTY, INC.
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1790215614 — HEALTH PROFESSIONALS OF HOLMES COUNTY, INC
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Directions to “HEALTH PROFESSIONALS OF HOLMES COUNTY, INC ” Practice Location

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