MEDICARE: HIGHLAND COUNTY COMMUNITY ACTION ORGANIZATION

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	261QF0050X	Non-Surgical Family Planning Clinic/Center

General Provider Information

NPI Number	:	1861848806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHLAND COUNTY COMMUNITY ACTION ORGANIZATION

Provider Business Mailing Address
First Line	:	62 E SUGARTREE ST
Second Line	:
City	:	WILMINGTON
State	:	OH
Zip	:	45177-2331
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	62 E SUGARTREE ST
Second Line	:
City	:	WILMINGTON
State	:	OH
Zip	:	45177-2331
Country	:	US
Telephone Number	:	937-393-3060
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JULIA WISE
Credential	:
Telephone Number	:	937-393-3060

Provider Enumeration Date	:	05/09/2016
Last Update Date	:	05/10/2016

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