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Organization

FIRST CARE INTEGRATED HEALTH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FANTA BERETAY CNP (NP/CEO)
(614) 226-5622
Entity
Organization

Contact information

Practice address
5150 E MAIN ST STE 102, COLUMBUS, OH 43213-2441
(614) 226-5622
Mailing address
6167 BUCKEYE PKWY, GROVE CITY, OH 43123-8387
(614) 493-9884

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
363LF0000X
Family Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
363LP2300X
Primary Care Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0227206
OH
Enumeration date
02/21/2020
Last updated
06/30/2023
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