THIRD STREET COMMUNITY CLINIC INC NPI 1972053452

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 1972053452. The provider is registered as an organization entity type.
The provider Is Doing Business As Five Points Primary Care.

The provider's business location address is:

200 PARK AVE W
MANSFIELD, OH
ZIP 44902-608
Phone: (419) 522-2239
Fax: (419) 525-6723

The provider's authorized official is Peggy Anderson .
The authorized official title is Ceo and has the following contact phone number (419) 526-7880.

The CLIA number assigned to this NPI record is 36D2121949 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/10/2016 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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