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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
1261QR1300XRural Health Clinic/Center

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 : 1790215614
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 :
Fax Number :
Provider Business Practice Location Address
First Line : 1261 WOOSTER RD STE 200
Second Line :
City : MILLERSBURG
State : OH
Zip : 44654-1570
Country : US
Telephone Number : 330-674-3333
Fax Number : 330-763-8679
Authorized Official
Title or Position : CFO
Name : JASON JUSTUS
Credential :
Telephone Number : 330-674-1584
Provider Enumeration Date : 06/13/2017
Last Update Date : 06/13/2017

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Directions to “HEALTH PROFESSIONALS OF HOLMES COUNTY, INC ” Practice Location

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