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Organization
PRIMESOURCE HEALTHCARE OF OHIO, INC.
Active
Organization
PRIMESOURCE HEALTHCARE OF OHIO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID FLEMING (PRESIDENT & CEO)
(847) 267-8200
Entity
Organization
Contact information
Practice address
4449 EASTON WAY, FLOOR 2, COLUMBUS, OH 43219-6093
(800) 317-0711
(847) 267-9440
Mailing address
2100 EAST LAKE COOK ROAD, SUITE 1100, BUFFALO GROVE, IL 60089-1815
(847) 267-8200
(877) 821-6402
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
152W00000X
Optometrist
—
—
213E00000X
Podiatrist
Primary
—
—
231H00000X
Audiologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000541771
ANTHEM
OH
05
—
2719062
—
OH
05
—
2733019
—
OH
05
—
2734554
—
OH
05
—
2758350
—
OH
Enumeration date
02/26/2007
Last updated
10/11/2011
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