Provider Demographics
NPI:1043478654
Name:MVHE INC
Entity Type:Organization
Organization Name:MVHE INC
Other - Org Name:MIAMI VALLEY CONSULTING PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PRUNIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-208-8213
Mailing Address - Street 1:2661 SALEM AVE DAVUE BUILDING
Mailing Address - Street 2:SUITE 220
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406
Mailing Address - Country:US
Mailing Address - Phone:937-279-8648
Mailing Address - Fax:937-567-4186
Practice Address - Street 1:2661 SALEM AVE DAVUE BUILDING
Practice Address - Street 2:SUITE 220
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406
Practice Address - Country:US
Practice Address - Phone:937-279-8648
Practice Address - Fax:937-567-4186
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MVHE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
9256331Medicare PIN