Provider Demographics
NPI:1609614601
Name:COMMUNITY AND RURAL HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:COMMUNITY AND RURAL HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LISZAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-334-8943
Mailing Address - Street 1:2221 HAYES AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-2632
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2221 HAYES AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-2632
Practice Address - Country:US
Practice Address - Phone:419-334-8943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY AND RURAL HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-16
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy