Healthcare Provider Details

I. General information

NPI: 1477473882
Provider Name (Legal Business Name): FORT FAMILY HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 COMMERCE ST
FORT RECOVERY OH
45846-8003
US

IV. Provider business mailing address

1100 COMMERCE ST PO BOX 555
FORT RECOVERY OH
45846
US

V. Phone/Fax

Practice location:
  • Phone: 419-375-5550
  • Fax: 419-375-5560
Mailing address:
  • Phone: 419-375-5550
  • Fax: 419-375-5560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KAREN ANN CHERILUS
Title or Position: LPN
Credential:
Phone: 419-375-5550