# CENTER STREET COMMUNITY CLINIC, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Center Street Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396481487
- **Authorized official:** AUDREY COBB (CFO)
- **Authorized official phone:** (740) 914-4372

## Contact information

- **Practice address:** 136 W CENTER ST, MARION, OH 43302-3704
- **Practice address phone:** (740) 914-4371
- **Practice address fax:** (740) 914-4372
- **Mailing address:** 136 W CENTER ST, MARION, OH 43302-3704
- **Mailing address phone:** (740) 914-4371
- **Mailing address fax:** (409) 144-3727

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/11/2022
- **Last updated:** 04/13/2023