Organization
WASHINGTON COUNTY FREE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN BOZIAN (BOARD PRESIDENT)
(740) 376-0261
Entity
Organization
Contact information
Practice address
208 3RD ST, MARIETTA, OH 45750-3001
(740) 376-0261
(740) 376-7160
Mailing address
PO BOX 804, MARIETTA, OH 45750-0804
(740) 376-0261
(740) 376-7160
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36D2003526
CLIA WAIVER
OH
Enumeration date
06/12/2014
Last updated
06/12/2014
Update your record
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