Health Professionals of Holmes County, Inc
Organization Active NPI Specialist · Berlin, OH
NPI 1801079702 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1801079702
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- HEALTH PROFESSIONALS OF HOLMES COUNTY, INC
- Practice address
- 4900 Oak Street
Berlin, OH 44610 - Phone
- (330) 893-1318
- Fax
- (330) 893-1485
- NPI assigned
- Dec 13, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- HEALTH PROFESSIONALS OF HOLMES COUNTY, INC
Authorized official
- Name
- Mr. Jason Justus
- Title
- Chief Financial Officer
- Phone
- (330) 674-1015
Other NPIs on the same Medicare enrollment 15
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070702000432 | OH | Part B Supplier - Clinic/Group Practice | 6002916194 |
Receives reassigned benefits from 94 practitioners 15 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Berlin, OH; Sugarcreek, OH; Millersburg, OH; Loudonville, OH; Dover, OH |
National Provider Directory
- Part of
- Health Professionals of Holmes County Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | OH | Yes |
Addresses
Primary practice location
4900 Oak Street
Berlin, OH 44610
Mailing address
1261 Wooster Rd
Suite 200
Millersburg, OH 44654-1568
Phone (330) 674-2822
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2811514 | Medicaid | OH |
Other names
- Pomerene Family Care
Other providers in Berlin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.