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NPI Code Detail

MEDICARE: THE BUCKEYE RANCH, INC

MEDICARE: THE BUCKEYE RANCH, 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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center12433OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13153/12433OTHEROHSTATE OF OHIO MACIL UPI #
22863718OTHEROHOHIO MITS PROVIDER ID

General Provider Information

NPI Number : 1871852582
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE BUCKEYE RANCH, INC
Provider Business Mailing Address
First Line : 5665 HOOVER ROAD
Second Line :
City : GROVE CITY
State : OH
Zip : 43123
Country : US
Telephone Number : 614-875-2371
Fax Number : 614-875-2366
Provider Business Practice Location Address
First Line : 5665 HOOVER RD
Second Line :
City : GROVE CITY
State : OH
Zip : 43123-9122
Country : US
Telephone Number : 614-384-7798
Fax Number : 614-384-7798
Authorized Official
Title or Position : HR CREDENTIALING SPECIALIST
Name : MS. LEIGH ANN TURNER
Credential :
Telephone Number : 614-396-6395
Provider Enumeration Date : 05/15/2012
Last Update Date : 09/25/2023

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Directions to “THE BUCKEYE RANCH, INC ” Practice Location

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