COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY (NPI# 1962828293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962828293 |
| Entity Type | Organization |
| Organization Name | COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY |
| Other Organization Name | INDIAN LAKE COMMUNITY HEALTH CENTER |
| Practice Address |
8200 State Route 366 Suite No. 1 Russells Point OH 43348-9670 |
| Mailing Address |
4879 St. Rt. 68 South West Liberty OH 43357 |
| Practice Telephone | 9375991411 |
| Practice Fax Number | 9375994128 |
| Mailing Telephone | 9375991411 |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2016-12-12 |
| Authorized Official Name | TARA D BAIR (PRESIDENT/CEO) |
| Authorized Official Telephone | 9378871013 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Indian Lake Community Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083215875 | Community Health & Wellness Partners of Logan County | Clinic/Center | 7208 Us Highway 68 N Ste 2, West Liberty, OH 43357-9663 | 2020-11-06 |
| 1295294890 | Community Health & Wellness Partners of Logan County | Clinic/Center | 8200 State Route 366 Ste 1, Russells Point, OH 43348-9670 | 2019-03-14 |
| 1497214001 | Community Health & Wellness Partners of Logan County | Clinic/Center | 212 E Columbus Ave Ste 1, Bellefontaine, OH 43311-2033 | 2019-03-14 |
| 1679032353 | Community Health & Wellness Partners of Logan County | Clinic/Center | 4879 Us Highway 68 S, West Liberty, OH 43357-9525 | 2019-03-13 |
| 1336649599 | Community Health & Wellness Partners of Logan County | Clinic/Center | 212 E Columbus Ave Ste 1, Bellefontaine, OH 43311 | 2018-02-14 |
| 1689005357 | Community Health & Wellness Partners of Logan County | Clinic/Center | 4879 Us Highway 68 S, West Liberty, OH 43357-9525 | 2013-12-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY | 212 E Columbus Ave, Bellefontaine, OH 43311-2033 |
| Street Address |
8200 STATE ROUTE 366 SUITE NO. 1 |
| City | RUSSELLS POINT |
| State | OH |
| Zip Code | 43348-9670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053386847 | Jeffrey L Holycross | Pharmacist | 8200 State Route 366, Russells Point, OH 43348-9670 | 2006-02-23 |
| 1992356356 | Center for Trauma Therapy and Counseling | Social Worker | 8200 State Route 366, Russells Point, OH 43348-9670 | 2019-09-26 |
| 1598999385 | William Gingerich | Social Worker | 8200 State Route 366, Ste 2b, Russells Point, OH 43348-9670 | 2009-05-07 |
| 1679745673 | Lakeview Medical, Inc. | Family Medicine | 8200 State Route 366, Russells Point, OH 43348-9670 | 2008-03-31 |
| 1770705345 | Paul V. Bonetzky Do | Clinic/Center | 8200 State Route 366, Russells Point, OH 43348-9670 | 2007-05-03 |
| 1891807806 | Jeffrey L Holycross | Pharmacy | 8200 State Route 366, Russells Point, OH 43348-9670 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932397411 | My Urban Clinic, Inc | Clinic/Center | 8200 Sr 366, Russell Point, OH 43348 | 2007-10-09 |
| 1992911317 | James Herbert Levan | Pharmacist | 120 W. Main St, Russells Point, OH 43348 | 2007-05-15 |
| 1891108478 | Matthew Castle | Pharmacist | 120 West Main Street, Russell's Point, OH 43348 | 2014-06-11 |
| 1255685178 | Sharon Burris | Pharmacist | 120 W. Main St., Russells Point, OH 43348 | 2012-10-30 |
| 1871765404 | Teresa Marie Robinson | Pharmacist | 120 West Main Street, Russells Point, OH 43348 | 2008-03-24 |
| 1124215652 | Costin Family Practice, Inc. | Family Medicine | 303 East Main Street, Russells Point, OH 43348 | 2007-09-28 |
| 1609904887 | Gregory W. Fogt | Pharmacist | 120 W. Main St., Russells Point, OH 43348-0636 | 2007-03-01 |
| 1083889000 | Brianne Nicole Huffman | Home Health Aide | 212 Oakcrest Ct, Russells Point, OH 43348-1937 | 2008-04-30 |
| 1326465113 | Monica Klinker | Physical Therapy Assistant | 140 Burkhart Ave, Russells Point, OH 43348-9552 | 2014-03-18 |
| 1336333988 | Joanna Carey Henry | Massage Therapist | 303 East Main Street, Suite 3, Russells Point, OH 43348-9601 | 2007-08-28 |
| Find all providers in zip 43348 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295294890 | Community Health & Wellness Partners of Logan County | Clinic/Center | 8200 State Route 366 Ste 1, Russells Point, OH 43348-9670 | 2019-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699380725 | Family Health Services of Erie County | Clinic/Center | 209 Lowell St, Castalia, OH 44824-9332 | 2020-09-15 |
| 1124633193 | Community Health Centers of Greater Dayton | Clinic/Center | 3805 Kings Hwy Rm C, Dayton, OH 45406-3577 | 2020-09-15 |
| 1669087649 | Community Health Centers of Greater Dayton | Clinic/Center | 2900 Shiloh Springs Rd, Ste Studio A, Trotwood, OH 45426-2139 | 2020-09-15 |
| 1639783996 | Erie County Office of Auditor | Clinic/Center | 34 Executive Dr Ste A, Norwalk, OH 44857-2490 | 2020-09-03 |
| 1083231872 | Health Partners of Western Ohio | Clinic/Center | 550 S Collett St Ste 1, Lima, OH 45805-3210 | 2020-06-29 |
| 1366068405 | Muskingum Valley Health Centers | Clinic/Center | 225 W Union Ave Ste 100, West Lafayette, OH 43845-1150 | 2020-06-24 |
| 1205452331 | Muskingum Valley Health Centers | Clinic/Center | 58601 Marietta Rd Ste 100, Byesville, OH 43723-9452 | 2020-06-24 |
| 1336777077 | Shawnee Mental Health Center Inc | Clinic/Center | 1225 Gallia St Rm 121, Portsmouth, OH 45662-4216 | 2020-03-30 |
| 1376177303 | Erie County Office of Auditor | Clinic/Center | 1925 Hayes Ave Ste B, Sandusky, OH 44870-4737 | 2020-02-28 |
| 1407480593 | Erie County Office of Auditor | Clinic/Center | 333 Buckeye Blvd Ste B, Port Clinton, OH 43452-2475 | 2020-02-27 |
| Find all providers with the same taxonomy | ||||
| City | RUSSELLS POINT |
| Zip Code | 43348 |
Please comment or provide details below to improve the information on COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY.
| 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.