THIRD STREET COMMUNITY CLINIC INC. NPI 1306499314

NPI Information

THIRD STREET COMMUNITY CLINIC, INC. is a federally qualified health center (fqhc) clinic center in Mansfield, OH. THIRD STREET COMMUNITY CLINIC, INC. NPI is 1306499314. The provider is registered as an organization entity type.

The provider's business location address is:

205 W COOK RD
MANSFIELD, OH
ZIP 44907-405
Phone: (419) 522-6191
Fax: (419) 525-6723

The provider's authorized official is Theresa Jeremy .
The authorized official title is Credentialing and has the following contact phone number (419) 522-6191.

The enumeration date for this NPI number is 7/18/2019 and was last updated on 2/25/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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