Provider Demographics
NPI:1982637161
Name:AMERICAN HEALTH NETWORK OF OHIO, LLC
Entity Type:Organization
Organization Name:AMERICAN HEALTH NETWORK OF OHIO, LLC
Other - Org Name:AMERICAN HEALTH NETWORK OF OHIO PROFESSIONAL CORPORATION
Other - Org Type:Other Name
Authorized Official - Title/Position:VP OPERATIONS OHIO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:COURTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-794-5053
Mailing Address - Street 1:5900 PARKWOOD PL
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-1216
Mailing Address - Country:US
Mailing Address - Phone:614-794-4500
Mailing Address - Fax:
Practice Address - Street 1:227 E LOUDON AVE
Practice Address - Street 2:
Practice Address - City:LOUDONVILLE
Practice Address - State:OH
Practice Address - Zip Code:44842-9662
Practice Address - Country:US
Practice Address - Phone:419-994-5581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN HEALTH NETWORK OF OHIO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-09
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0254237Medicaid
OHCI6090Medicare PIN
OHAM9283822Medicare PIN