Organization
HEALTHSOURCE OF OHIO, INC.
Active
Other names
HealthSource: Mt. Orab
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH W PRATHER II MD (CEO)
(513) 707-4041
Entity
Organization
Contact information
Practice address
150 HEALTH PARTNERS CIR, MOUNT ORAB, OH 45154-8610
(937) 444-2514
(937) 444-4818
Mailing address
424 WARDS CORNER RD STE 200, LOVELAND, OH 45140-6966
(513) 707-4041
(513) 576-1020
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0824184
—
OH
01
—
CH7473
RAILROAD MEDICARE
OH
Enumeration date
06/17/2006
Last updated
09/18/2024
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