# BROADWAY FAMILY MEDICINE INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083696538
- **Authorized official:** ROSE EBEL DO (PRESIDENT)
- **Authorized official phone:** (513) 932-1936

## Contact information

- **Practice address:** 1470 N BROADWAY ST, SUITE100, LEBANON, OH 45036-1744
- **Practice address phone:** (513) 932-1936
- **Practice address fax:** (513) 932-3105
- **Mailing address:** PO BOX 4723, BELFAST, ME 04915-4723
- **Mailing address phone:** (513) 932-1936
- **Mailing address fax:** (513) 932-3105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/18/2005
- **Last updated:** 09/20/2018