Basic Information
| Provider Information | |||||||||
| NPI: | 1629618681 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 HIGH ST FL 3 | ||||||||
| Address2: | |||||||||
| City: | HAMILTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450116078 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134541460 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3045 BUSENBARK RD STE B | ||||||||
| Address2: | |||||||||
| City: | TRENTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450677611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134541111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2020 | ||||||||
| LastUpdateDate: | 08/18/2021 | ||||||||
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| AuthorizedOfficialLastName: | BELDEN | ||||||||
| AuthorizedOfficialFirstName: | JULIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 5134541468 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No ID Information.