NPIMap

Organization Active NPI

Healthsource of Ohio Inc

  • Community/Retail Pharmacy
  • Batavia, OH
National Provider Identifier
1891009502
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
02-2076650 Issued in OH
Legal business name
HEALTHSOURCE OF OHIO INC
Practice address
2055 Hospital Dr
Batavia, OH 45103-1964
Phone
(513) 732-0700
Fax
(513) 732-0642
NPI assigned
Aug 5, 2010
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Joseph W Prather II, MD
Title
Ceo
Phone
(513) 707-4041

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 24

Practitioners 85

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 85

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160927001097 OH Part B Supplier - Mass Immunization (Roster Biller Only) 2264328749 Practice locations: Batavia, OH

All facility ownership & control disclosures 1

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Healthsource Batavia Family PracticeBatavia, OH, CCN 361820 Federally qualified health center Operational/Managerial Control (100%) Oct 1, 1976

National Provider Directory

National Provider Directory
Tax ID family
West Union Family Healt45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

Locations

2055 Hospital Dr
Ste 320
Batavia, OH 45103
Phone (513) 732-0700

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 02-2076650 OH Primary

Addresses

NPPES NPI Registry

Primary practice location

2055 Hospital Dr
Batavia, OH 45103-1964

Mailing address

2055 Hospital Dr
Suite 130
Batavia, OH 45103-1964
Phone (513) 732-0700

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
2126485OtherPK
3077843MedicaidOH

Other names 1

NPPES NPI Registry
  • HEALTHSOURCE OF OHIO BATAVIA PHARMACY Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 18, 2024.

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1891009502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 HOSPITAL DR",
            "address_2": "SUITE 130",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "451031964",
            "telephone_number": "513-732-0700",
            "fax_number": "513-732-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 HOSPITAL DR",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "451031964",
            "telephone_number": "513-732-0700",
            "fax_number": "513-732-0642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF OHIO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-05",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "PRATHER II",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "513-707-4041",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "02-2076650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2126485",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3077843",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTHSOURCE OF OHIO BATAVIA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Batavia, OH

Sources for this page

Verify at the official NPI Registry.