Provider Demographics
NPI:1457869489
Name:FAMILY PRACTICE WESTCARE, LLC
Entity Type:Organization
Organization Name:FAMILY PRACTICE WESTCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CNP
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PERLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-878-7285
Mailing Address - Street 1:3421 FARM BANK WAY
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-1974
Mailing Address - Country:US
Mailing Address - Phone:614-878-7285
Mailing Address - Fax:614-878-1703
Practice Address - Street 1:3421 FARM BANK WAY
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-1974
Practice Address - Country:US
Practice Address - Phone:614-878-7285
Practice Address - Fax:614-878-1703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-11
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X
OH363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0270865Medicaid