Goble Oneal Hammonds

Individual provider Active NPI Case Manager/Care Coordinator · MC Dermott, OH

NPI 1992480883 · NPPES record last updated Jun 19, 2023

Key facts

NPI
1992480883
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
6431 State Route 104
MC Dermott, OH 45652-8943
Phone
(740) 876-8627
NPI assigned
Jun 19, 2023
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Ohio Premier Recovery, LLC Current
since Jun 25, 2023
Accepting new patients
Southern Ohio Premier Recovery, LLC Current
since Jun 25, 2023
Accepting new patients

Locations

6587 State Route 104
Mc Dermott, OH 45652

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OH Yes

Addresses

Primary practice location

6431 State Route 104
MC Dermott, OH 45652-8943

Mailing address

6587 State Route 104
MC Dermott, OH 45652-8943
Phone (740) 981-6987

Other providers in MC Dermott, OH

All providers in MC Dermott, OH · Case Manager/Care Coordinator in Ohio

Sources for this page

Verify at the official NPI Registry.