Provider Demographics
NPI:1659566586
Name:PICKAWAY HEALTH SERVICES
Entity Type:Organization
Organization Name:PICKAWAY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:C
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-420-8078
Mailing Address - Street 1:9085 SOUTHERN STREET AT S. R., SUITE A
Mailing Address - Street 2:BERGER MEDICAL C
Mailing Address - City:ORIENT
Mailing Address - State:OH
Mailing Address - Zip Code:43146
Mailing Address - Country:US
Mailing Address - Phone:614-277-4652
Mailing Address - Fax:
Practice Address - Street 1:9085 SOUTHERN STREET AT S. R., SUITE A
Practice Address - Street 2:BERGER MEDICAL C
Practice Address - City:ORIENT
Practice Address - State:OH
Practice Address - Zip Code:43146
Practice Address - Country:US
Practice Address - Phone:614-277-4652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center