Provider Demographics
NPI:1538291927
Name:MEDICAL SERVICE ASSOCIATES OF XENIA, INC.
Entity Type:Organization
Organization Name:MEDICAL SERVICE ASSOCIATES OF XENIA, INC.
Other - Org Name:MEDICAL SERVICE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHYSICIAN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DRENTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-352-2788
Mailing Address - Street 1:PO BOX 76587
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44101-6500
Mailing Address - Country:US
Mailing Address - Phone:800-451-8186
Mailing Address - Fax:937-291-2962
Practice Address - Street 1:50 N PROGRESS DR
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-2666
Practice Address - Country:US
Practice Address - Phone:937-372-7691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies