MEDICARE: HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION

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	261QR1300X	Rural Health Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number	:	1497712533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION

Provider Business Mailing Address
First Line	:	1275 N HIGH ST
Second Line	:
City	:	HILLSBORO
State	:	OH
Zip	:	45133-8273
Country	:	US
Telephone Number	:	937-393-6100
Fax Number	:	937-393-1658

Provider Business Practice Location Address
First Line	:	1092 JEFFERSON ST
Second Line	:
City	:	GREENFIELD
State	:	OH
Zip	:	45123-8319
Country	:	US
Telephone Number	:	937-981-1121
Fax Number	:	937-981-5660

Authorized Official
Title or Position	:	VP OF PROFESSIONAL SERVICES
Name	:	TRACY COOMER
Credential	:
Telephone Number	:	937-393-6100

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	02/09/2017

Similar Medicare Providers

1043202187 — MRS. ESTHER GRACE PABLO KANAYJORN MD
Practice Location Address:

1092 JEFFERSON ST
GREENFIELD, OH
45123-8319

Practice Phone: 937-981-1121
Practice Fax: 937-981-5660

1437141561 — RAYMOND W MICK CNP
Practice Location Address:

1092 JEFFERSON ST
GREENFIELD, OH
45123-8319

Practice Phone: 937-981-1121
Practice Fax: 937-981-5660

1861994402 — HIGHLAND HEALTH PROVIDERS CORP
Practice Location Address:

1092 JEFFERSON ST
GREENFIELD, OH
45123-8319

Practice Phone: 937-989-1121
Practice Fax:

1962229229 — MRS. KELSEY CLOUD MSN, APRN, FNP-BC
Practice Location Address:

1092 JEFFERSON ST
GREENFIELD, OH
45123-8319

Practice Phone: 937-981-1121
Practice Fax: 937-981-5660

1083114474 — BRAUN R. LOWERY LCDC II/QMHS
Practice Location Address:

910 SOUTH ST
GREENFIELD, OH
45123-1249

Practice Phone: 877-997-3224
Practice Fax:

1962090092 — BRAYDAN SHELTON
Practice Location Address:

910 SOUTH ST
GREENFIELD, OH
45123-1249

Practice Phone: 877-997-3224
Practice Fax:

Directions to “HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.