Organization
HEALTHSOURCE OF OHIO, INC.
Active
Other names
HealthSource: Eastgate Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH W PRATHER II MD (CEO)
(513) 707-4041
Entity
Organization
Contact information
Practice address
4627 AICHOLTZ RD, CINCINNATI, OH 45244-1447
(513) 753-2820
(513) 753-2824
Mailing address
424 WARDS CORNER RD STE 200, LOVELAND, OH 45140-6966
(513) 707-4011
(513) 576-1020
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0300966
—
OH
Enumeration date
03/26/2007
Last updated
09/18/2024
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