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KETTERING AFFILIATED HEALTH SERVICES NPI 1003919176


NPI Information

NPI: 1003919176
Provider Name: KETTERING AFFILIATED HEALTH SERVICES

Doing Business As: KETTERING BREAST EVALUATION CENTER

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
580 LINCOLN PARK BOULEVARD, SUITE 200
KETTERING BREAST EVALUATION CENTER
KETTERING, OH
ZIP 45429
Phone: (937) 299-0099
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KETTERING AFFILIATED HEALTH SERVICES is a clinic center in Kettering, OH. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). KETTERING AFFILIATED HEALTH SERVICES NPI is 1003919176. The provider is registered as an organization entity type.
The provider Is Doing Business As Kettering Breast Evaluation Center.

The provider's business location address is:

580 LINCOLN PARK BOULEVARD, SUITE 200
KETTERING BREAST EVALUATION CENTER
KETTERING, OH
ZIP 45429
Phone: (937) 299-0099

The provider's authorized official is Brett Spenst .
The authorized official title is Kmc Network Cfo and has the following contact phone number (937) 395-8816.

The enumeration date for this NPI number is 9/6/2006 and was last updated on 6/15/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
19212174MEDICARE ID-TYPE UNSPECIFIEDOHIO
22287412MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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