Provider Demographics
NPI:1144827478
Name:HEALTH PROFESSIONALS OF HOLMES COUNTY, INC
Entity type:Organization
Organization Name:HEALTH PROFESSIONALS OF HOLMES COUNTY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:JUSTUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-674-1584
Mailing Address - Street 1:981 WOOSTER RD
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44654-1536
Mailing Address - Country:US
Mailing Address - Phone:330-674-1584
Mailing Address - Fax:330-674-9314
Practice Address - Street 1:121 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LOUDONVILLE
Practice Address - State:OH
Practice Address - Zip Code:44842-1247
Practice Address - Country:US
Practice Address - Phone:419-994-0212
Practice Address - Fax:330-763-2063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health