Provider Demographics
NPI:1811368210
Name:HEALTH PARTNERS OF WESTERN OHIO
Entity Type:Organization
Organization Name:HEALTH PARTNERS OF WESTERN OHIO
Other - Org Name:TIFFIN COMMUNITY HEALTH CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:419-222-1680
Mailing Address - Street 1:486 W PERRY ST
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-1902
Mailing Address - Country:US
Mailing Address - Phone:419-222-1680
Mailing Address - Fax:419-549-5670
Practice Address - Street 1:486 W PERRY ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-1902
Practice Address - Country:US
Practice Address - Phone:419-222-1680
Practice Address - Fax:419-549-5670
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH PARTNERS OF WESTERN OHIO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy