ACTIVATE HEALTHCARE - BRYAN CLINIC


Address: 500 W Mulberry St, Suite 101, Bryan, OH 43506-1142
Phone: 4195193336

ACTIVATE HEALTHCARE - BRYAN CLINIC (NPI# 1952834020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952834020
Entity Type Organization
Organization Name ACTIVATE HEALTHCARE - BRYAN CLINIC
Practice Address 500 W Mulberry St
Suite 101
Bryan
OH 43506-1142
Mailing Address 2010 N Damen Ave Unit F
Chicago
IL 60647-3286
Practice Telephone 4195193336
Practice Fax Number 4192129219
Mailing Telephone 7082488592
Enumeration Date 2017-04-06
Last Update Date 2018-11-07
Authorized Official Name DEBRA GEIHSLER (PRINCIPAL)
Authorized Official Telephone 7736973144
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Office Location

Street Address 500 W MULBERRY ST
SUITE 101
City BRYAN
State OH
Zip Code 43506-1142

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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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1346427010 Stephen S. Tseng, Md, Pa Clinic/Center 3201 University Dr E Ste 345, Bryan, TX 77802-3484 2008-01-24

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Competitor

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City BRYAN
Zip Code 43506

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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