Healthcare Provider Details

I. General information

NPI: 1073426250
Provider Name (Legal Business Name): COMMUNITY AND RURAL HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 VAN BUREN ST
FOSTORIA OH
44830-1533
US

IV. Provider business mailing address

502 VAN BUREN ST
FOSTORIA OH
44830-1533
US

V. Phone/Fax

Practice location:
  • Phone: 419-334-3869
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOSEPH LISZAK III
Title or Position: CEO
Credential:
Phone: 419-334-8943