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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
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