MEDICARE: COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY

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	261QF0400X	Federally Qualified Health Center (FQHC)
2	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1952904286
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY

Provider Business Mailing Address
First Line	:	212 E COLUMBUS AVE STE 1
Second Line	:
City	:	BELLEFONTAINE
State	:	OH
Zip	:	43311-2033
Country	:	US
Telephone Number	:	937-599-1411
Fax Number	:	937-599-4128

Provider Business Practice Location Address
First Line	:	7208 US HIGHWAY 68 N STE 2
Second Line	:
City	:	WEST LIBERTY
State	:	OH
Zip	:	43357-9663
Country	:	US
Telephone Number	:	937-599-1411
Fax Number	:	937-599-4128

Authorized Official
Title or Position	:	CEO
Name	:	TARA DAWN BAIR
Credential	:
Telephone Number	:	937-599-1411

Provider Enumeration Date	:	11/19/2020
Last Update Date	:	05/16/2025

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Directions to “COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY ” Practice Location

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