MEDICARE: COMMUNITY HEALTH CENTERS OF GREATER DAYTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center		OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558548842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH CENTERS OF GREATER DAYTON

Provider Business Mailing Address
First Line	:	PO BOX 932293
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-2293
Country	:	US
Telephone Number	:	937-586-9733
Fax Number	:

Provider Business Practice Location Address
First Line	:	2132 E 3RD ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45403-1977
Country	:	US
Telephone Number	:	937-208-6850
Fax Number	:	937-208-6896

Authorized Official
Title or Position	:	SENIOR BILLING SPECIALIST
Name	:	DANA BALLOU
Credential	:
Telephone Number	:	937-586-9733

Provider Enumeration Date	:	01/29/2008
Last Update Date	:	06/10/2026

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