Healthcare Provider Details

I. General information

NPI: 1013224203
Provider Name (Legal Business Name): CRAWFORD HEALTH CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 12/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 E MANSFIELD ST
BUCYRUS OH
44820-2018
US

IV. Provider business mailing address

1820 E MANSFIELD ST
BUCYRUS OH
44820-2018
US

V. Phone/Fax

Practice location:
  • Phone: 419-562-1413
  • Fax: 419-562-1424
Mailing address:
  • Phone: 419-562-1413
  • Fax: 419-562-1424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DUANE A. ALBRIGHT
Title or Position: ADMINISTRATOR
Credential:
Phone: 419-562-1413