Provider Demographics
NPI:1952633026
Name:FULTON COUNTY HEALTH CENTER
Entity Type:Organization
Organization Name:FULTON COUNTY HEALTH CENTER
Other - Org Name:FULCARE BEHAVIOR HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JENEE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SEIBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-330-2606
Mailing Address - Street 1:725 S SHOOP AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSEON
Mailing Address - State:OH
Mailing Address - Zip Code:43567-1702
Mailing Address - Country:US
Mailing Address - Phone:419-335-2015
Mailing Address - Fax:419-330-2602
Practice Address - Street 1:725 S SHOOP AVE
Practice Address - Street 2:
Practice Address - City:WAUSEON
Practice Address - State:OH
Practice Address - Zip Code:43567-1702
Practice Address - Country:US
Practice Address - Phone:419-335-2015
Practice Address - Fax:419-330-2602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH36M333Medicare Oscar/Certification