CHARTER OAK HEALTH CENTER, INC. (NPI# 1447719091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447719091 |
| Entity Type | Organization |
| Organization Name | CHARTER OAK HEALTH CENTER, INC. |
| Practice Address |
693 Bloomfield Ave Ste 101 Bloomfield CT 06002-2489 |
| Mailing Address |
21 Grand St Hartford CT 06106-1541 |
| Practice Telephone | 8605507500 |
| Practice Fax Number | 8602164164 |
| Mailing Telephone | 8605507500 |
| Mailing Fax Number | 8605507529 |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2019-03-19 |
| Authorized Official Name | TIM POWERS (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Telephone | 8605507500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073774709 | Charter Oak Health Center, Inc. | Clinic/Center | 574 Park St, Hartford, CT 06106-4617 | 2008-06-25 |
| 1851552582 | Charter Oak Health Center, Inc. | Clinic/Center | 437 Sheldon St, Hartford, CT 06106-1939 | 2008-06-25 |
| 1912169640 | Charter Oak Health Center, Inc. | Clinic/Center | 34 Huyshope Ave, Hartford, CT 06106-2815 | 2008-06-25 |
| 1093274771 | Charter Oak Health Center, Inc. | Clinic/Center | 1755 Park St, Hartford, CT 06106-2160 | 2019-03-13 |
| 1396906020 | Charter Oak Health Center, Inc. | Clinic/Center | 21 Grand St, Hartford, CT 06106-1541 | 2008-06-25 |
| 1902068638 | Charter Oak Health Center, Inc. | Clinic/Center | 401 New Britain Ave, Hartford, CT 06106-3833 | 2008-06-25 |
| 1669633392 | Charter Oak Health Center, Inc. | Clinic/Center | 118 Main St, Hartford, CT 06106-1817 | 2008-06-25 |
| 1003078734 | Charter Oak Health Center, Inc. | Clinic/Center | 21 Grand St, Hartford, CT 06106-1541 | 2008-06-25 |
| 1639331366 | Charter Oak Health Center, Inc. | Clinic/Center | 21 Grand St, Hartford, CT 06106-1541 | 2008-06-25 |
| 1922260652 | Charter Oak Health Center, Inc. | Clinic/Center | 21 Grand St, Hartford, CT 06106-1541 | 2008-06-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | CHARTER OAK HEALTH CENTER, INC. | 21 Grand Street, Hartford, CT 06106 |
| Street Address |
693 BLOOMFIELD AVE STE 101 |
| City | BLOOMFIELD |
| State | CT |
| Zip Code | 06002-2489 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275177404 | Jessica Listorti | Psychiatry & Neurology | 693 Bloomfield Ave Ste 101, Bloomfield, CT 06002-2489 | 2019-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558908897 | Duncaster, Inc. | Clinic/Center | 30 Loeffler Rd., Bloomfield, CT 06002 | 2019-12-05 |
| 1104467919 | Caroline Suzanne Carey Oesch | Counselor | 71 West Dudley St, Bloomfield, CT 06002 | 2019-10-02 |
| 1679047534 | Inspire Me, LLC | Counselor | 1-2 Camelot Drive, Bloomfield, CT 06002 | 2019-01-14 |
| 1508348947 | Rebecca Perry | Student in an Organized Health Care Education/Training Program | 693 Bloomfield Avenue, Bloomfield, CT 06002 | 2018-09-01 |
| 1760996946 | Monique Edwards | Social Worker | 705 New Briatin Ave, Chd, Bloomfield, CT 06002 | 2017-11-27 |
| 1225564412 | Merva E Dixon | Nurse Practitioner | 38 Hill Farm Rd, Bloomfield, CT 06002 | 2017-05-07 |
| 1538602610 | Jaime Acevedo | Counselor | 571 Bloomfield Ave, Bloomfield, CT 06002 | 2016-11-22 |
| 1669835138 | Jacob Badura | Pharmacist | 799-824 Park Ave, Bloomfield, CT 06002 | 2016-04-01 |
| 1316283328 | Julie Jason Farrelly | Counselor | 45 Wintonbury Ave Ste 102, Bloomfield, CT 06002 | 2012-12-19 |
| 1184915860 | Rachel Benedetto Scott | Surgery | 6 Northwestern Drive, Suite 305, Bloomfield, CT 06002 | 2011-04-28 |
| Find all providers in zip 06002 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1760877864 | First Choice Health Centers, Inc. | Clinic/Center | 94 Connecticut Boulevard, East Hartford, CT 06108 | 2015-04-06 |
| 1669874855 | First Choice Health Centers, Inc. | Clinic/Center | 20 Maple Street, Maple Street School, Vernon, CT 06066 | 2014-09-19 |
| 1669874087 | First Choice Health Centers, Inc. | Clinic/Center | 70 Loveland Hill Road, Rockville High School, Vernon, CT 06066 | 2014-09-17 |
| 1548677982 | Community Health Center Inc | Clinic/Center | 730 State Pier Rd, New London, CT 06320-5862 | 2014-07-17 |
| 1982950473 | Community Health Center Inc | Clinic/Center | 112 Bow Ln, Middletown, CT 06457-4710 | 2012-08-02 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMFIELD |
| Zip Code | 06002 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.