Healthcare Provider Details

I. General information

NPI: 1588326029
Provider Name (Legal Business Name): MUSKINGUM VALLEY HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2021
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

956 MOXAHALA AVE
ZANESVILLE OH
43701-5533
US

IV. Provider business mailing address

33 S 5TH ST
ZANESVILLE OH
43701-3510
US

V. Phone/Fax

Practice location:
  • Phone: 740-891-9000
  • Fax: 740-891-9001
Mailing address:
  • Phone: 740-891-9000
  • Fax: 740-487-0021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DANIEL ATKINSON
Title or Position: CFO
Credential:
Phone: 740-891-9000