Provider Demographics
NPI:1205509775
Name:HEALTH PARTNERS FREE CLINIC
Entity type:Organization
Organization Name:HEALTH PARTNERS FREE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CORCORAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-332-0894
Mailing Address - Street 1:1300 N COUNTY ROAD 25A
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-1359
Mailing Address - Country:US
Mailing Address - Phone:937-332-0894
Mailing Address - Fax:
Practice Address - Street 1:1300 N COUNTY ROAD 25A
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1359
Practice Address - Country:US
Practice Address - Phone:937-332-0894
Practice Address - Fax:937-339-7084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center