Provider Demographics
NPI:1073973541
Name:OXFORD COLLEGE CORNER CLINIC
Entity Type:Organization
Organization Name:OXFORD COLLEGE CORNER CLINIC
Other - Org Name:OXFORD FREE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SASSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-524-5426
Mailing Address - Street 1:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-0390
Mailing Address - Country:US
Mailing Address - Phone:513-524-5426
Mailing Address - Fax:513-524-5482
Practice Address - Street 1:5151 MORNING SUN RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-9545
Practice Address - Country:US
Practice Address - Phone:513-524-5426
Practice Address - Fax:513-524-5482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261Q00000X251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable