Providence Health Partners

Primary specialty

Research Clinic/CenterTaxonomy code 261QR1100X

Legal business name

PROVIDENCE HEALTH PARTNERS

Doing business as

Center for Clinical Research

Practice address

2912 Springboro Rd
Suite 201
Moraine, OH 45439-1674

Phone

(937) 297-8999

Fax

(937) 298-9673

NPI assigned

Jun 26, 2012

Organization subpart

Yes

Parent organization

PROVIDENCE HEALTH PARTNERSAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Edward A Hubach, DO

Title

Board President

Phone

(937) 849-1363

Specialties & licenses 1

Addresses

Other names 1

• Center for Clinical Research Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Providence Health Partners

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340755200000",
    "number": "1912261744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2912 SPRINGBORO RD",
            "address_2": "SUITE 201",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391674",
            "telephone_number": "937-297-8999",
            "fax_number": "937-298-9673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2912 SPRINGBORO RD",
            "address_2": "SUITE 201",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391674",
            "telephone_number": "937-297-8999",
            "fax_number": "937-298-9673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE HEALTH PARTNERS",
        "enumeration_date": "2012-06-26",
        "last_updated": "2012-06-27",
        "status": "A",
        "authorized_official_last_name": "HUBACH",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BOARD PRESIDENT",
        "authorized_official_telephone_number": "937-849-1363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Clinical Research",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacqueline Price
• Prime Care Providers, LLC
• Lindsey J Proctor
• Project Cure Inc
• Project Cure, Inc.
• Providence Medical Group (PMG Lab)
• Providence Medical Group
• Providence Medical Group, Inc. (PMG Vascular Imaging)
• Providian
• Trudy Eileen Prugh, M.S. PCC-S

• Research Clinic/Center in Moraine, OH
• Providers in Moraine, OH by specialty
• Research Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.