Healthcare Provider Details

I. General information

NPI: 1265366744
Provider Name (Legal Business Name): FAIRFIELD COMMINITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 E MAIN ST RM 2303
AMANDA OH
43102-9330
US

IV. Provider business mailing address

220 E WALNUT ST
LANCASTER OH
43130-4464
US

V. Phone/Fax

Practice location:
  • Phone: 740-277-6043
  • Fax:
Mailing address:
  • Phone: 740-277-6043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DANIEL FISHER
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 740-277-6043