| Community Care I, Inc. | |
|
8153 Main Street Old Fort OH 44861 | |
| (419) 992-4231 | |
| (419) 992-4722 |
| Full Name | Community Care I, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 8153 Main Street, Old Fort, Ohio |
| Authorized Official Name and Position | Denise Woolley (DIRECTOR, MEDICAL STAFF SERVICES) |
| Authorized Official Contact | 4193346624 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Care I, Inc. 715 S Taft Ave Fremont OH 43420-3200 Ph: (419) 334-6624 | Community Care I, Inc. 8153 Main Street Old Fort OH 44861 Ph: (419) 992-4231 |
| NPI Number | 1619901915 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 10/20/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619901915 | NPI | - | NPPES |
| 0238951 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |