Provider Demographics
NPI:1730364837
Name:NORTH HAMPTON FAMILY CARE INC
Entity type:Organization
Organization Name:NORTH HAMPTON FAMILY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ESTELLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GALLARDO
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:937-964-8669
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:NORTH HAMPTON
Mailing Address - State:OH
Mailing Address - Zip Code:45349-0459
Mailing Address - Country:US
Mailing Address - Phone:937-964-8669
Mailing Address - Fax:937-964-8665
Practice Address - Street 1:275 W CLARK ST
Practice Address - Street 2:
Practice Address - City:NORTH HAMPTON
Practice Address - State:OH
Practice Address - Zip Code:45349
Practice Address - Country:US
Practice Address - Phone:937-964-8669
Practice Address - Fax:937-964-8665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty