Provider Demographics
NPI:1659316644
Name:GROVE CITY FAMILY HEALTH, INC
Entity type:Organization
Organization Name:GROVE CITY FAMILY HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUNSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-875-8949
Mailing Address - Street 1:6024 HOOVER ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-8131
Mailing Address - Country:US
Mailing Address - Phone:614-875-8949
Mailing Address - Fax:614-539-4610
Practice Address - Street 1:6024 HOOVER ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-8131
Practice Address - Country:US
Practice Address - Phone:614-875-8949
Practice Address - Fax:614-539-4610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2170583Medicaid
OH2170583Medicaid