Organization
PRIMARY HEALTH CARE OF ASHTABULA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE PETERS (PRESIDENT)
(440) 563-5028
Entity
Organization
Contact information
Practice address
5266 STATE ROUTE 45, ROME, OH 44085-9404
(440) 563-5028
(440) 563-3044
Mailing address
5266 STATE ROUTE 45, ROME, OH 44085-9404
(440) 563-5028
(440) 563-3044
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2218906
—
OH
Enumeration date
06/19/2006
Last updated
10/15/2008
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