Provider Demographics
NPI:1235453515
Name:FAMILY CARE CENTERS OF OHIO
Entity Type:Organization
Organization Name:FAMILY CARE CENTERS OF OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:STATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-542-5000
Mailing Address - Street 1:30680 BAINBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2282
Mailing Address - Country:US
Mailing Address - Phone:440-542-5023
Mailing Address - Fax:440-542-5029
Practice Address - Street 1:30680 BAINBRIDGE RD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2282
Practice Address - Country:US
Practice Address - Phone:440-542-5000
Practice Address - Fax:440-542-5029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-16
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty