| Bellefontaine Community Health Center | |
|
212 E Columbus Ave Ste 1 Bellefontaine OH 43311 | |
| (937) 599-1411 | |
| (937) 599-4128 |
| Full Name | Bellefontaine Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 212 E Columbus Ave Ste 1, Bellefontaine, Ohio |
| Authorized Official Name and Position | Tara Dawn Bair (CEO) |
| Authorized Official Contact | 9375991411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bellefontaine Community Health Center 4879 Us Highway 68 S West Liberty OH 43357-9525 Ph: (937) 599-1411 | Bellefontaine Community Health Center 212 E Columbus Ave Ste 1 Bellefontaine OH 43311 Ph: (937) 599-1411 |
| NPI Number | 1336649599 |
|---|---|
| Provider Enumeration Date | 02/14/2018 |
| Last Update Date | 07/03/2018 |
| Medicare PECOS PAC ID | 8022247469 |
|---|---|
| Medicare Enrollment ID | O20181030001849 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336649599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Maple Leaf Family And Sports Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2211 Timber Trail, Bellefontaine, OH 43311 Phone: 937-592-3808 Fax: 937-593-8404 |