Organization
PROVIDENCE HEALTH PARTNERS
Active
Parent organization
PROVIDENCE HEALTH PARTNERS
Other names
Center for Clinical Research
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH PARTNERS
Authorized official
DR. EDWARD A HUBACH DO (BOARD PRESIDENT)
(937) 849-1363
Entity
Organization
Contact information
Practice address
2912 SPRINGBORO RD, SUITE 201, MORAINE, OH 45439-1674
(937) 297-8999
(937) 298-9673
Mailing address
2912 SPRINGBORO RD, SUITE 201, MORAINE, OH 45439-1674
(937) 297-8999
(937) 298-9673
Taxonomy
Speciality
Code
Description
License number
State
261QR1100X
Research Clinic/Center
Primary
—
—
Other
Enumeration date
06/26/2012
Last updated
06/27/2012
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