Provider Demographics
NPI:1659504785
Name:MVHE INC
Entity Type:Organization
Organization Name:MVHE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:RALOFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-499-8205
Mailing Address - Street 1:3170 KETTERING BLVD
Mailing Address - Street 2:BUILDING B 3RD FLOOR
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1924
Mailing Address - Country:US
Mailing Address - Phone:937-991-3188
Mailing Address - Fax:937-223-9811
Practice Address - Street 1:3170 KETTERING BLVD
Practice Address - Street 2:BUILDING B 3RD FLOOR
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-1924
Practice Address - Country:US
Practice Address - Phone:937-991-3188
Practice Address - Fax:937-223-9811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0081661Medicaid
OH0081661Medicaid