Provider Demographics
NPI:1548279714
Name:FULTON COUNTY HEALTH CENTER
Entity type:Organization
Organization Name:FULTON COUNTY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-335-2015
Mailing Address - Street 1:725 S SHOOP AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSEON
Mailing Address - State:OH
Mailing Address - Zip Code:43567-1702
Mailing Address - Country:US
Mailing Address - Phone:419-335-2015
Mailing Address - Fax:419-330-2602
Practice Address - Street 1:725 S SHOOP AVE
Practice Address - Street 2:
Practice Address - City:WAUSEON
Practice Address - State:OH
Practice Address - Zip Code:43567-1702
Practice Address - Country:US
Practice Address - Phone:419-335-2015
Practice Address - Fax:419-330-2602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No273R00000XHospital UnitsPsychiatric Unit
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0006461140OtherAETNA
37283OtherGALLAGHER
OH2077729Medicaid
MI2676172Medicaid
OH03598OtherPARAMOUNT
OH0379880Medicaid
CA4806OtherRAILROAD MEDICARE
000000157552OtherBLUE CROSS
OH05044OtherPARAMOUNT
OH128471100OtherUS DEPT OF LABOR ACS
OH600091OtherBUCKEYE PROVIDER NUMBER
MI2676350Medicaid
OH000000157552OtherANTHEM PROVIDER NUMBER
OH000000352405OtherANTHEM
OH05044OtherPARAMOUNT PROVIDER ID
CA4806OtherRAILROAD MEDICARE
OH0379880Medicaid
37283OtherGALLAGHER
MI2676350Medicaid