Provider Demographics
NPI:1700207065
Name:BUCKEYE WELLNESS CONSULTANTS LLC
Entity Type:Organization
Organization Name:BUCKEYE WELLNESS CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZACKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-236-8000
Mailing Address - Street 1:23811 CHAGRIN BLVD.
Mailing Address - Street 2:STE: 220
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-831-4484
Mailing Address - Fax:
Practice Address - Street 1:2040 BRICE RD
Practice Address - Street 2:STE 160
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068
Practice Address - Country:US
Practice Address - Phone:614-856-9901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty