Provider Demographics
NPI:1235274341
Name:HEALTH SPECIALISTS OF DAYTON INC
Entity Type:Organization
Organization Name:HEALTH SPECIALISTS OF DAYTON INC
Other - Org Name:JAMES R RADEMACHER MD COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:PRUNIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-208-8252
Mailing Address - Street 1:105 SUGAR CAMP CIR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-1962
Mailing Address - Country:US
Mailing Address - Phone:937-222-3937
Mailing Address - Fax:937-223-5416
Practice Address - Street 1:105 SUGAR CAMP CIR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-1962
Practice Address - Country:US
Practice Address - Phone:937-222-3937
Practice Address - Fax:937-223-5416
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH SPECIALISTS OF DAYTON INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-20
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9353865Medicare PIN