Healthcare Provider Details

I. General information

NPI: 1093813768
Provider Name (Legal Business Name): ALLEN COUNTY HEALTH PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 E 8TH ST
LIMA OH
45804-2482
US

IV. Provider business mailing address

441 E 8TH ST PHARMACY
LIMA OH
45804-2482
US

V. Phone/Fax

Practice location:
  • Phone: 419-221-3723
  • Fax: 419-221-1726
Mailing address:
  • Phone: 419-221-3723
  • Fax: 419-221-1726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number021612850
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER CLARK
Title or Position: PHCY DIRECTOR
Credential: RPH
Phone: 419-222-1680