Provider Demographics
NPI:1861445520
Name:MVHE INC
Entity Type:Organization
Organization Name:MVHE INC
Other - Org Name:ASSOCIATED SPECIALISTS OF INTERNAL MEDICINE
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 1:7707 PARAGON RD
Mailing Address - Street 2:STE 101
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4041
Mailing Address - Country:US
Mailing Address - Phone:937-208-6920
Mailing Address - Fax:937-208-6948
Practice Address - Street 1:7707 PARAGON RD
Practice Address - Street 2:STE 101
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4041
Practice Address - Country:US
Practice Address - Phone:937-208-6920
Practice Address - Fax:937-208-6948
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MVHE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-17
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2831430Medicaid
OH9187611Medicare PIN
OH2831430Medicaid