# CENTRAL STATE UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Central State Health & Wellness Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871057992
- **Authorized official:** KAREN MATHEWS M.D. (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (937) 376-6076

## Contact information

- **Practice address:** 1400 BRUSH ROW RD., WILBERFORCE, OH 45384
- **Practice address phone:** (937) 376-6076
- **Practice address fax:** (937) 376-6647
- **Mailing address:** P.O. BOX 1004, WILBERFORCE, OH 45384
- **Mailing address phone:** (937) 376-6076
- **Mailing address fax:** (937) 376-6446

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/23/2019
- **Last updated:** 01/23/2019