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Five County Alcohol/drup Program In
Non-Pharmacy Dispensing Site in Alvordton, Ohio
NPI 1093772386

Five County Alcohol/drup Program In is a Non-Pharmacy Dispensing Site based in Defiance, OH. Five County Alcohol/drup Program In practices in Alvordton, OH. The NPI Number for Five County Alcohol/drup Program In is 1093772386 and holds a License No. 0559 (Ohio).

The current practice location address for Five County Alcohol/drup Program In is 109 W Main St, Alvordton, OH and can be reached out via phone at 419-924-2029 and via fax at 419-924-2061.

Location: 109 W Main St, Alvordton, OH, 43512-2758
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1093772386
Provider Name
Five County Alcohol/drup Program In
Credential
Provider Entity Type
Organization
Address
109 W Main St, Alvordton, OH, 43512-2758
Phone Number
419-924-2029
Fax Number
419-924-2061
Provider Enumeration Date
04/28/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
10998 01 OH MACSIS UPI
institution
Provider Business Practice Location Address Details
Address
109 W Main St
City
Alvordton
State
Ohio
Zip
43501-9763
Phone Number
419-924-2029
Fax Number
419-924-2061
person
Provider Business Mailing Address Details
Address
109 W Main St
City
Alvordton
State
Ohio
Zip
43501-9763
Phone Number
419-924-2029
Fax Number
419-924-2061
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
0559 (Ohio)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
0559 (Ohio)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 3
Type
Suppliers
Classification
Non-Pharmacy Dispensing Site
Speciality
-
Taxonomy
332900000X
License No.
0559 (Ohio)
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
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