# THIRD STREET COMMUNITY CLINIC, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THIRD STREET COMMUNITY CLINIC, INC
- **Other names:** Third Street Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1497485973
- **Legal business name:** THIRD STREET COMMUNITY CLINIC, INC
- **Authorized official:** PEGGY ANDERSON (CEO)
- **Authorized official phone:** (419) 526-7880

## Contact information

- **Practice address:** 600 W 3RD ST, MANSFIELD, OH 44906-2633
- **Practice address phone:** (419) 522-6191
- **Practice address fax:** (419) 525-6723
- **Mailing address:** 1404 PARK AVE W, STE 2, MANSFIELD, OH 44906-2633
- **Mailing address phone:** (419) 522-6191
- **Mailing address fax:** (419) 525-6723

## 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:** 06/16/2022
- **Last updated:** 08/13/2026