Provider Demographics
NPI:1790343846
Name:GERIATRIC CARE PROVIDERS INC
Entity Type:Organization
Organization Name:GERIATRIC CARE PROVIDERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:937-671-7028
Mailing Address - Street 1:1896 AMYS RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-7192
Mailing Address - Country:US
Mailing Address - Phone:937-671-7028
Mailing Address - Fax:937-534-0166
Practice Address - Street 1:1896 AMYS RIDGE CT
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45434-7192
Practice Address - Country:US
Practice Address - Phone:937-671-7028
Practice Address - Fax:937-534-0166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH633650OtherMEDICARE