Healthcare Provider Details

I. General information

NPI: 1730593336
Provider Name (Legal Business Name): FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 08/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 ANDERSON ST
NEW MADISON OH
45346-9715
US

IV. Provider business mailing address

5735 MEEKER RD
GREENVILLE OH
45331-1180
US

V. Phone/Fax

Practice location:
  • Phone: 937-548-3806
  • Fax: 937-548-3552
Mailing address:
  • Phone: 937-548-9680
  • Fax: 937-548-3552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateOH

VIII. Authorized Official

Name: MRS. JEAN YOUNG
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 937-548-3806