MEDICARE: HEALTHCARE 2000 COMMUNITY CLINIC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center
2	122300000X	Dentist

General Provider Information

NPI Number	:	1023694171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE 2000 COMMUNITY CLINIC INC

Provider Business Mailing Address
First Line	:	1874 CLEVELAND RD
Second Line	:
City	:	WOOSTER
State	:	OH
Zip	:	44691-2263
Country	:	US
Telephone Number	:	330-262-2500
Fax Number	:	330-262-2500

Provider Business Practice Location Address
First Line	:	1874 CLEVELAND RD
Second Line	:
City	:	WOOSTER
State	:	OH
Zip	:	44691-2263
Country	:	US
Telephone Number	:	330-262-2500
Fax Number	:	330-262-2500

Authorized Official
Title or Position	:	CEO
Name	:	MARK YODER
Credential	:
Telephone Number	:	330-262-2500

Provider Enumeration Date	:	03/19/2021
Last Update Date	:	06/05/2026

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