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NPI Code Detail

MEDICARE: HOPEWELL HEALTH CENTERS INC

MEDICARE: HOPEWELL HEALTH CENTERS 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
1261QF0400XFederally Qualified Health Center (FQHC)OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942291794
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOPEWELL HEALTH CENTERS INC
Provider Business Mailing Address
First Line : 1049 WESTERN AVE
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-1104
Country : US
Telephone Number : 740-773-4366
Fax Number : 740-775-7855
Provider Business Practice Location Address
First Line : 1049 WESTERN AVE
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-1104
Country : US
Telephone Number : 740-773-4366
Fax Number : 740-775-7855
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MARK A BRIDENBAUGH
Credential :
Telephone Number : 740-773-4366
Provider Enumeration Date : 11/01/2005
Last Update Date : 02/21/2014

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45601-1104
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Practice Fax: 740-775-7855
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1194718049 — JOHN UCCI M.D.
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1049 WESTERN AVE
CHILLICOTHEE, OH
45601-1104
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Practice Fax: 740-775-7855
1336187566 — MRS. VICKY KAY PARKER CNP
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1049 WESTERN AVE
CHILLICOTHEE, OH
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1659468908 — HOPEWELL HEALTH CENTERS INC
Practice Location Address:
1049 WESTERN AVE
CHILLICOTHEE, OH
45601-1104
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Practice Fax: 740-775-7855
1174648992 — DR. SUMAN SHARMA MD
Practice Location Address:
1049 WESTERN AVE
CHILLICOTHEE, OH
45601-1104
Practice Phone: 740-773-4366
Practice Fax: 740-775-2299

Directions to “HOPEWELL HEALTH CENTERS INC ” Practice Location

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