Provider Demographics
NPI:1598717308
Name:HEALTH SPECIALISTS OF DAYTON INC
Entity Type:Organization
Organization Name:HEALTH SPECIALISTS OF DAYTON INC
Other - Org Name:RANJIT R PULLARKAT MD COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PRUNIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-208-8213
Mailing Address - Street 1:3535 SALEM AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-2645
Mailing Address - Country:US
Mailing Address - Phone:937-274-4060
Mailing Address - Fax:937-275-1750
Practice Address - Street 1:3535 SALEM AVE
Practice Address - Street 2:STE 201
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-2645
Practice Address - Country:US
Practice Address - Phone:937-274-4060
Practice Address - Fax:937-275-1750
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH SPECIALISTS OF DAYTON INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-17
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2607889Medicaid
9353865Medicare PIN