Organization
MEDICAL HOME PRIMARY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL L CROWDER (ADMINISTRATIVE DIRECTOR)
(740) 455-3304
Entity
Organization
Contact information
Practice address
3620 COURT DR, ZANESVILLE, OH 43701-6456
(740) 454-1248
(740) 454-8183
Mailing address
PO BOX 1821, ZANESVILLE, OH 43702-1821
(740) 455-3304
(740) 455-3686
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35075041D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2078648
—
OH
Enumeration date
09/07/2010
Last updated
09/07/2010
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