Healthcare Provider Details

I. General information

NPI: 1609935030
Provider Name (Legal Business Name): WOOD COUNTY FAMILY CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 W WOOSTER ST SUITE 202
BOWLING GREEN OH
43402-2644
US

IV. Provider business mailing address

960 W WOOSTER ST SUITE 202
BOWLING GREEN OH
43402-2644
US

V. Phone/Fax

Practice location:
  • Phone: 419-353-3454
  • Fax: 419-353-3808
Mailing address:
  • Phone: 419-353-3454
  • Fax: 419-353-3808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: AMJAD FAROOQ
Title or Position: OWNER
Credential: M.D.
Phone: 419-353-3454