Provider Demographics
NPI:1407001126
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:740-986-4008
Mailing Address - Street 1:9391 SR 56 WEST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43164
Mailing Address - Country:US
Mailing Address - Phone:740-986-4008
Mailing Address - Fax:
Practice Address - Street 1:9391 STATE ROUTE 56
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:OH
Practice Address - Zip Code:43164-9743
Practice Address - Country:US
Practice Address - Phone:740-986-4008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty