Provider Demographics
NPI:1679676993
Name:HEALTHQUEST OF MT ORAB INC
Entity type:Organization
Organization Name:HEALTHQUEST OF MT ORAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:PENDELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-404-5301
Mailing Address - Street 1:131 N POINT DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT ORAB
Mailing Address - State:OH
Mailing Address - Zip Code:45154-8366
Mailing Address - Country:US
Mailing Address - Phone:937-444-1166
Mailing Address - Fax:888-757-7699
Practice Address - Street 1:131 N POINT DR
Practice Address - Street 2:
Practice Address - City:MOUNT ORAB
Practice Address - State:OH
Practice Address - Zip Code:45154-8366
Practice Address - Country:US
Practice Address - Phone:937-444-1166
Practice Address - Fax:888-315-2865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2592565Medicaid
OH6180730001Medicare NSC
OH9355261Medicare PIN