CENTER STREET COMMUNITY CLINIC INC NPI 1346417417

NPI Information

CENTER STREET COMMUNITY CLINIC INC is a federally qualified health center (fqhc) clinic center in Marion, OH. CENTER STREET COMMUNITY CLINIC INC NPI is 1346417417. The provider is registered as an organization entity type.
The provider Is Doing Business As Center Street Community Clinic.

The provider's business location address is:

205 W CENTER ST
SUITE 200
MARION, OH
ZIP 43302-700
Phone: (740) 751-4189
Fax: (740) 751-4866

The provider's authorized official is Cliff G Edwards .
The authorized official title is Ceo/executive Director and has the following contact phone number (740) 751-6380.

The enumeration date for this NPI number is 5/8/2008 and was last updated on 1/21/2015.

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:

Other Identifiers

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

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