FAIRFIELD COMMUNITY HEALTH CENTER NPI 1396024212

NPI Information

NPI: 1396024212
Provider Name: FAIRFIELD COMMUNITY HEALTH CENTER
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 36D0328447

Address:
1055 W MARKET ST
SUITE H
BALTIMORE, OH
ZIP 43105
Phone: (740) 862-4183
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FAIRFIELD COMMUNITY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Baltimore, OH. FAIRFIELD COMMUNITY HEALTH CENTER NPI is 1396024212. The provider is registered as an organization entity type.

The provider's business location address is:

1055 W MARKET ST
SUITE H
BALTIMORE, OH
ZIP 43105-283
Phone: (740) 862-4183

The provider's authorized official is Lisa Evangelista .
The authorized official title is Ceo and has the following contact phone number (740) 277-6043.

The CLIA number assigned to this NPI record is 36D0328447 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/9/2011 and was last updated on 3/3/2022.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			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	Other Provider Identifier Issuer
1	0069122	MEDICAID	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: 11/14/2023

NPI Synchronization or Removal

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