Organization
THE OHIO MASONIC HOME
Active
Other names
Springfield Masonic Community
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT BUCHANAN (CHIEF FINANCIAL OFFICER)
(937) 525-4975
Entity
Organization
Contact information
Practice address
3 MASONIC DR, SPRINGFIELD, OH 45504-3658
(937) 325-1531
(937) 525-8291
Mailing address
3 MASONIC DR, SPRINGFIELD, OH 45504-3658
(937) 325-1531
(937) 525-8291
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5208
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000002797
ANTHEM
OH
05
—
2005850
—
OH
Enumeration date
08/27/2006
Last updated
06/23/2014
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