Provider Demographics
NPI:1043427966
Name:PRIMARY HEALTH PARTNERS, INC.
Entity Type:Organization
Organization Name:PRIMARY HEALTH PARTNERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:WETHERINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-393-6481
Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-0298
Mailing Address - Country:US
Mailing Address - Phone:937-393-6481
Mailing Address - Fax:937-840-0777
Practice Address - Street 1:1275 N HIGH ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-8273
Practice Address - Country:US
Practice Address - Phone:937-393-6481
Practice Address - Fax:937-840-0777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35073826261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2433585Medicaid
OH2140061Medicaid
1588622260OtherDR. HOLDERMAN NPI
1831177302OtherDR. WETHERINGTON NPI
1831177302OtherDR. WETHERINGTON NPI
OH0892616Medicare ID - Type UnspecifiedDR. WETHERINGTON MEDICARE
OH4131024Medicare ID - Type UnspecifiedDR. HOLDERMAN MEDICARE
OH2140061Medicaid