Middletown Community Health Center, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MIDDLETOWN COMMUNITY HEALTH CENTER, INC.

Practice address

221 Broad St
Milford, PA 18337-1355

Phone

(845) 343-7614

Fax

(845) 343-5390

NPI assigned

Dec 20, 2013

Last updated

Dec 20, 2013By 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

Maryjo Jobity

Title

Cfo

Phone

(845) 343-7614

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912328741. Details of each certification follow.

• CCN 391065 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 391065

Legal name

MIDDLETOWN COMMUNITY HEALTH CENTER INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Nov 24, 2015

Last certification

Nov 24, 2015

Ownership / control type

For profit – corporation

Facility address

221 Broad Street
Milford, PA 18337

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387497600000",
    "number": "1912328741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 ORCHARD ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109405004",
            "telephone_number": "845-343-7614",
            "fax_number": "845-343-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 BROAD ST",
            "city": "MILFORD",
            "state": "PA",
            "postal_code": "183371355",
            "telephone_number": "845-343-7614",
            "fax_number": "845-343-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLETOWN COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-20",
        "last_updated": "2013-12-20",
        "status": "A",
        "authorized_official_last_name": "JOBITY",
        "authorized_official_first_name": "MARYJO",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "845-343-7614"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leann Mathews
• Karissa McLean, MS LBS
• Linda Joy Mendelsohn, MD
• Merakey Pennsylvania
• Brieana Meshko
• Kyle Mihalik
• Milford Clinic Physicians P a (Milford Urgent Care)
• Milford Counseling and Consultation LLC
• Milford Fire Department
• Milford Internal Medicine Associates PC

• Federally Qualified Health Center (FQHC) in Milford, PA
• Providers in Milford, PA by specialty
• Federally Qualified Health Center (FQHC) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.