Organization
THIRD STREET COMMUNITY CLINIC INC
Active
Organization
THIRD STREET COMMUNITY CLINIC INC
Active
Parent organization
THIRD STREET COMMUNITY CLINIC INC
Other names
Shelby OB/GYN
Organization subpart
Yes
Provider details
NPI number
Legal business name
THIRD STREET COMMUNITY CLINIC INC
Authorized official
JARED POLLICK (CEO)
(419) 522-6191
Entity
Organization
Contact information
Practice address
199 W MAIN ST, 2ND FLOOR, SHELBY, OH 44875-1490
(419) 525-6732
Mailing address
199 W MAIN ST, 2ND FLOOR, SHELBY, OH 44875-1490
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/17/2015
Last updated
12/30/2015
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