Provider Demographics
NPI:1164528097
Name:FAMILY HEALTH PARTNERS, INC.
Entity Type:Organization
Organization Name:FAMILY HEALTH PARTNERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HULL
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:419-935-0196
Mailing Address - Street 1:315 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:OH
Mailing Address - Zip Code:44890-1652
Mailing Address - Country:US
Mailing Address - Phone:419-935-0196
Mailing Address - Fax:419-933-7616
Practice Address - Street 1:315 CRESTWOOD DR
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:OH
Practice Address - Zip Code:44890-1652
Practice Address - Country:US
Practice Address - Phone:419-935-0196
Practice Address - Fax:419-933-7616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0913131Medicaid