Center Street Community Clinic Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

CENTER STREET COMMUNITY CLINIC INC

Practice address

205 West Center Street
Suite 200
Marion, OH 43302-3700

Phone

(740) 375-6030

Fax

(740) 382-8291

NPI assigned

Jul 5, 2006

Last updated

Apr 16, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cliff G Edwards

Title

Ceo

Phone

(740) 375-6030

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1346271608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 WEST CENTER STREET",
            "address_2": "SUITE 200",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433023700",
            "telephone_number": "740-375-6030",
            "fax_number": "740-382-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WEST CENTER STREET",
            "address_2": "SUITE 200",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433023700",
            "telephone_number": "740-375-6030",
            "fax_number": "740-382-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER STREET COMMUNITY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "CLIFF",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "740-375-6030"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2807734",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Castle
• Lisa Castle, CDCA
• Bradley Neil Casto, HEARING INSTRUMENT S
• Erik Caudill
• Kimberly Caudill
• Center Street Community Clinic Inc (Center Street Community Clinic)
• Center Street Community Clinic Inc (Center Street Community Health Center)
• Center Street Community Clinic Inc (Morrow Family Health Center Dental)
• Center Street Community Clinic, Inc
• Center Street Community Clinic, Inc

• Primary Care Clinic/Center in Marion, OH
• Providers in Marion, OH by specialty
• Primary Care Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.