Physical Medicine Center Of St Elizabeth
Clinic/Center, Multi-Specialty in Dayton, OH. Organization (NPI-2).
NPI number1407472004
StatusActive
Last updated in NPPESJun 19, 2020
Details
- NPI
- 1407472004
- Entity type
- Organization (NPI-2)
- Legal business name
- Physical Medicine Center Of St Elizabeth
- Organization subpart
- No
- Enumeration date
- Jun 19, 2020
- Certification date
- Jun 19, 2020
- Last updated
- Jun 19, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | Yes |
| 111N00000X | Chiropractor | – | – | |
| 261QP2000X | Clinic/Center, Physical Therapy | – | – | |
| 261QP3300X | Clinic/Center, Pain | – | – |
Practice location
1 Elizabeth Pl Ste 1100bDayton, OH 45417-3445
Phone 937-813-7666 · Fax 937-813-7667
Mailing address
1 Elizabeth Pl Ste 1100bDayton, OH 45417-3445
Phone 937-813-7666 · Fax 937-813-7667
Authorized official
Fuad Amer
Owner
5132130919
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