Provider Demographics
NPI:1386709194
Name:FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Entity type:Organization
Organization Name:FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:M
Authorized Official - Last Name:POLLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-548-3806
Mailing Address - Street 1:5735 MEEKER RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-1180
Mailing Address - Country:US
Mailing Address - Phone:937-548-2953
Mailing Address - Fax:937-548-5372
Practice Address - Street 1:5735 MEEKER RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1180
Practice Address - Country:US
Practice Address - Phone:937-548-2953
Practice Address - Fax:937-548-5372
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-22
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH021284450OtherSTATE LICENSE
OH2286851Medicaid