Healthcare Provider Details

I. General information

NPI: 1235135054
Provider Name (Legal Business Name): CITY OF COSHOCTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 07/21/2021
Certification Date: 07/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BROWNS LN
COSHOCTON OH
43812-2044
US

IV. Provider business mailing address

400 BROWNS LN
COSHOCTON OH
43812-2044
US

V. Phone/Fax

Practice location:
  • Phone: 740-622-1736
  • Fax: 740-623-4559
Mailing address:
  • Phone: 740-622-1736
  • Fax: 740-623-4559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. KATHERINE A CLARK
Title or Position: HEALTH COMMISSIONER
Credential: RN, BSN
Phone: 740-622-1736