Provider Demographics
NPI:1437227212
Name:SOUTH CENTRAL OHIO FOUNDATION INC
Entity Type:Organization
Organization Name:SOUTH CENTRAL OHIO FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHENGCHUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:YEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-775-4055
Mailing Address - Street 1:249 S PAINT ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-3831
Mailing Address - Country:US
Mailing Address - Phone:740-775-4055
Mailing Address - Fax:740-775-4055
Practice Address - Street 1:249 S PAINT ST STE 101
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-3831
Practice Address - Country:US
Practice Address - Phone:740-775-4055
Practice Address - Fax:740-775-4055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service