# THIRD STREET COMMUNITY CLINIC, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THIRD STREET COMMUNITY CLINIC, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1144130071
- **Legal business name:** THIRD STREET COMMUNITY CLINIC, INC
- **Authorized official:** JASON BILYJ (PHARMACY DIRECTOR)
- **Authorized official phone:** (419) 522-6191

## Contact information

- **Practice address:** 31 E MAIN ST, SHELBY, OH 44875-1262
- **Practice address phone:** (419) 525-6729
- **Practice address fax:** (419) 730-3590
- **Mailing address:** 1404 PARK AVE W STE 2, ONTARIO, OH 44906-2719
- **Mailing address phone:** (419) 526-7872

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336I0012X | Institutional Pharmacy | — | NULL | — |
| 3336M0002X | Mail Order Pharmacy | — | NULL | — |
| 3336M0003X | Managed Care Organization Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/11/2026
- **Last updated:** 10/14/2026