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NPI Code Detail

MEDICARE: ADENA EMERGENCY PHYSICIANS, INC

MEDICARE: ADENA EMERGENCY PHYSICIANS, 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
1207P00000XEmergency Medicine Physician1402125OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5DA6516OTHEROHRRMEDICARE GRP PROVIDER#

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000319598OTHEROHANTHEM
3C37329OTHEROHHUMANA GRP PROVIDER#
4202766801OTHEROHDEPARTMENT OF LABOR GRP#
6020407000OTHEROHFEDERAL BLACK LUNG GRP#
7203397OTHEROHEEOICP GRP PROVIDER#

General Provider Information

NPI Number : 1609878073
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADENA EMERGENCY PHYSICIANS, INC
Provider Business Mailing Address
First Line : 4750 HEMPSTEAD STATION DR
Second Line :
City : KETTERING
State : OH
Zip : 45429-5164
Country : US
Telephone Number : 800-875-0136
Fax Number : 937-619-4231
Provider Business Practice Location Address
First Line : 550 MIRABEAU ST
Second Line :
City : GREENFIELD
State : OH
Zip : 45123-1617
Country : US
Telephone Number : 937-981-2116
Fax Number : 937-981-9238
Authorized Official
Title or Position : CEO
Name : DR. WILLIAM A COLE JR.
Credential :
Telephone Number : 800-726-3627
Provider Enumeration Date : 08/15/2005
Last Update Date : 11/02/2012

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Directions to “ADENA EMERGENCY PHYSICIANS, INC ” Practice Location

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