Provider Demographics
NPI:1942874334
Name:PRICE, THOMAS JUSTIN (QMHS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JUSTIN
Last Name:PRICE
Suffix:
Gender:M
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E WILSON BRIDGE RD STE 250
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2397
Mailing Address - Country:US
Mailing Address - Phone:740-877-5404
Mailing Address - Fax:
Practice Address - Street 1:150 E WILSON BRIDGE RD STE 250
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2397
Practice Address - Country:US
Practice Address - Phone:740-877-5404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator