Provider Demographics
NPI:1083179097
Name:INTECARE, INC.
Entity Type:Organization
Organization Name:INTECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZAINEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-874-5766
Mailing Address - Street 1:530 E DAYTON YELLOW SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-6432
Mailing Address - Country:US
Mailing Address - Phone:937-874-5766
Mailing Address - Fax:937-874-5774
Practice Address - Street 1:530 E DAYTON YELLOW SPRINGS RD
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-6432
Practice Address - Country:US
Practice Address - Phone:937-874-5766
Practice Address - Fax:937-874-5774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0697009Medicaid