Provider Demographics
NPI:1508949231
Name:HUBER HEIGHTS MEDICAL CENTER INC
Entity Type:Organization
Organization Name:HUBER HEIGHTS MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:NMI
Authorized Official - Last Name:FRONISTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-233-0132
Mailing Address - Street 1:6096 BRANDT PIKE
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424
Mailing Address - Country:US
Mailing Address - Phone:937-233-0132
Mailing Address - Fax:937-233-9127
Practice Address - Street 1:6096 BRANDT PIKE
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424
Practice Address - Country:US
Practice Address - Phone:937-233-0132
Practice Address - Fax:937-233-9127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH074879Medicaid
OH9282091Medicare PIN
A71026Medicare UPIN