Organization
FAIRFIELD COMMUNITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA EVANGELISTA (CEO)
(740) 277-6043
Entity
Organization
Contact information
Practice address
1055 W MARKET ST, SUITE H, BALTIMORE, OH 43105-1283
(740) 277-6043
Mailing address
220 E WALNUT ST, LANCASTER, OH 43130-4464
(740) 277-6043
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0069122
—
OH
Enumeration date
08/09/2011
Last updated
07/17/2023
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