| Center Street Community Clinic Inc | |
|
126 Harding Way E Galion OH 44833-1901 | |
| (740) 751-6380 | |
| Not Available |
| Full Name | Center Street Community Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 126 Harding Way E, Galion, Ohio |
| Authorized Official Name and Position | Audrey Cobb (CFO) |
| Authorized Official Contact | 7407514531 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center Street Community Clinic Inc 136 W Center St Marion OH 43302-3704 Ph: (740) 751-4531 | Center Street Community Clinic Inc 126 Harding Way E Galion OH 44833-1901 Ph: (740) 751-6380 |
| NPI Number | 1942840871 |
|---|---|
| Provider Enumeration Date | 01/08/2020 |
| Last Update Date | 01/08/2020 |
| Medicare PECOS PAC ID | 7012815210 |
|---|---|
| Medicare Enrollment ID | O20200807001502 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942840871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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