Organization

Primesource Healthcare Of Ohio, Inc

Dentist in Columbus, OH(View on Map)

Legal Business Name

Primesource Healthcare Of Ohio, Inc

NPI Number

1235304775

NPI Type

Organization

Enumeration Date

04/25/2008

Specialties

(Taxonomies)

Name

Code

122300000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

2100 EAST LAKE COOK ROAD
4449 EASTON WAY

City

Buffalo Grove
Columbus

State

IL
OH

Postal Code

60089-1815
43219-6093

Country

US
US

Telephone Number

(847) 267-8200
(800) 317-0711

Authorized Official

Name

Mr. David Fleming

Title or Position

PRESIDENT & CEO

Telephone Number

(847) 267-8200

Identifiers

Identifier

2719062

Identifier State

OH

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/12/2011

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