MY COMMUNITY HEALTH CENTER NPI 1588117147

NPI Information

NPI: 1588117147
Provider Name: MY COMMUNITY HEALTH CENTER
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 36D2128481

Address:
2600 7TH ST SW
CANTON, OH
ZIP 44710
Phone: (330) 363-6211
Get Directions

MY COMMUNITY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Canton, OH. MY COMMUNITY HEALTH CENTER NPI is 1588117147. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2600 7TH ST SW
CANTON, OH
ZIP 44710-709
Phone: (330) 363-6211

The provider's authorized official is Terry Regula .
The authorized official title is Ceo and has the following contact phone number (330) 363-3179.

The CLIA number assigned to this NPI record is 36D2128481 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/1/2016 and was last updated on 4/2/2020.

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	Primary
1	207V00000X	Obstetrics & Gynecology		No
2	207Q00000X	Family Medicine		No
3	207R00000X	Internal Medicine		No
4	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	0322293	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: 4/28/2024

NPI Synchronization or Removal

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