CENTER STREET COMMUNITY CLINIC INC NPI 1346271608

NPI Information

NPI: 1346271608
Provider Name: CENTER STREET COMMUNITY CLINIC INC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 36D0885041

Address:
205 WEST CENTER STREET
SUITE 200
MARION, OH
ZIP 43302
Phone: (740) 375-6030
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CENTER STREET COMMUNITY CLINIC INC is a primary care clinic center in Marion, OH. CENTER STREET COMMUNITY CLINIC INC NPI is 1346271608. The provider is registered as an organization entity type.

The provider's business location address is:

205 WEST CENTER STREET
SUITE 200
MARION, OH
ZIP 43302-700
Phone: (740) 375-6030
Fax: (740) 382-8291

The provider's authorized official is Cliff G Edwards .
The authorized official title is Ceo and has the following contact phone number (740) 375-6030.

The CLIA number assigned to this NPI record is 36D0885041 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/5/2006 and was last updated on 4/16/2008.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care		OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	CE9339281	MEDICARE ID-TYPE UNSPECIFIED	OHIO
2	2807734	MEDICAID	OHIO
3	9339281	MEDICARE PIN	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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