PROSPECT FAMILY MEDICINE, INC.; NPI #1487895967

Contact Information

PROSPECT FAMILY MEDICINE, INC.

102 WATER STREET
PROSPECT, OH 43342

Phone: 740-494-2624
Fax: 740-494-9013
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Primary Care	261QP2300X

Indicates primary specialty

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NPI Profile & details for PROSPECT FAMILY MEDICINE, INC.

NPI Number 1487895967

LBN Legal business name PROSPECT FAMILY MEDICINE, INC.

Authorized official MARK PIACENTINI - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/13/2009

Last updated 05/17/2013 - About 13 years ago

Identifiers

OH	License #	35054820P
OH	Medicaid	0669174

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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