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General NPI Number Information
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NPI Number | 1669087649
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH CENTERS OF GREATER DAYTON
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 2900 SHILOH SPRINGS RD STE STUDIO A
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City | TROTWOOD
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State | OH
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Zip | 45426-2139
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Country | US
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Telephone | 937-528-6830
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Fax |
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Provider Business Mailing Address
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Address Line | 1323 W 3RD ST
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City | DAYTON
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State | OH
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Zip | 45402-6714
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Country | US
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Telephone | 937-586-9733
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | GREGORY HOPKINS
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Credential |
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Telephone | 937-586-9733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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