# HEALTHSERVE PRIMARY CARE LLC

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

## Provider details

- **NPI number:** 1669896239
- **Authorized official:** MICHAEL C BOURLAND (CFO)
- **Authorized official phone:** (614) 442-2431

## Contact information

- **Practice address:** 5263 NIKE STATION WAY, HILLIARD, OH 43026-7449
- **Practice address phone:** (614) 876-2100
- **Practice address fax:** (614) 876-2120
- **Mailing address:** 2939 KENNY RD STE 200, COLUMBUS, OH 43221-2406
- **Mailing address phone:** (614) 442-2431
- **Mailing address fax:** (614) 442-2426

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QP2000X | Physical Therapy Clinic/Center | PT008883 | OH | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/18/2014
- **Last updated:** 06/03/2014