Organization
RICHARD D WATKINS CANTON COMMUNITY CLINIC, INC.
Active
Other names
CANTON COMMUNITY CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY A GEMBAROSKY (CHIEF FINANCIAL OFFICER)
(330) 454-2000
Entity
Organization
Contact information
Practice address
2725 LINCOLN ST E, CANTON, OH 44707-2769
(330) 454-2000
(330) 454-6184
Mailing address
2725 LINCOLN ST E, CANTON, OH 44707-2769
(330) 454-2000
(330) 454-6184
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/29/2007
Last updated
05/08/2008
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