Provider Demographics
NPI:1528362183
Name:CORPORATE HEALTH OF OHIO INC
Entity Type:Organization
Organization Name:CORPORATE HEALTH OF OHIO INC
Other - Org Name:PUBLIC SAFETY HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:LOVETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-743-9474
Mailing Address - Street 1:235 INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-4429
Mailing Address - Country:US
Mailing Address - Phone:937-743-9474
Mailing Address - Fax:937-743-9475
Practice Address - Street 1:235 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-4429
Practice Address - Country:US
Practice Address - Phone:937-743-9474
Practice Address - Fax:937-743-9475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35058433208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH940080FFFFMedicare PIN