Provider Demographics
NPI:1225040090
Name:PICKAWAY HEALTH SERVICES
Entity Type:Organization
Organization Name:PICKAWAY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:C
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-420-8078
Mailing Address - Street 1:617 LANCASTER PIKE
Mailing Address - Street 2:SUITE C
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-8826
Mailing Address - Country:US
Mailing Address - Phone:740-420-8078
Mailing Address - Fax:
Practice Address - Street 1:210 SHARON RD
Practice Address - Street 2:SUITE D
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1498
Practice Address - Country:US
Practice Address - Phone:740-420-8422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty