Public record

CMS Federally Qualified Health Center All Owners

Associate id: 5698762235 · 50 matching records

Enrollment id
O20091210000403
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3173855723
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2018-07-30
First name - owner
CRYSTA
Last name - owner
BLOOMINGDALE
Enrollment id
O20091210000403
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3375709702
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2014-07-23
First name - owner
AUSTIE
Middle name - owner
M
Last name - owner
AUKER
Title - owner
CFO
Enrollment id
O20091210000403
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3375709702
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2014-07-23
First name - owner
AUSTIE
Middle name - owner
M
Last name - owner
AUKER
Title - owner
CFO
Enrollment id
O20091210000403
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3779939707
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2023-07-10
First name - owner
ALAN
Last name - owner
AYETTE
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20091210000403
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
4183644123
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2017-07-31
First name - owner
MICHAEL
Middle name - owner
ROBERT
Last name - owner
MAHER
Title - owner
BOARD MEMBER
Enrollment id
O20091210000403
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
4880987080
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2016-04-25
First name - owner
SONJA
Last name - owner
ETZELL
Title - owner
BOARD MEMBER
Enrollment id
O20091210000403
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
5092047738
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2019-08-05
First name - owner
JOY
Last name - owner
GREER
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20091210000403
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
5092197467
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2022-08-01
First name - owner
CASSIDY
Last name - owner
HELMAN
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20091210000403
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
5991845612
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2014-06-23
First name - owner
KATHY
Middle name - owner
S
Last name - owner
O'DELL
Title - owner
BOARD MEMBER
Enrollment id
O20091210000403
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
6901905603
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2020-05-22
First name - owner
JARED
Middle name - owner
M
Last name - owner
POLLICK
Title - owner
CEO
Enrollment id
O20091210000403
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
6901905603
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2020-05-22
First name - owner
JARED
Middle name - owner
M
Last name - owner
POLLICK
Title - owner
CEO
Enrollment id
O20091210000403
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
7618943952
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2022-08-01
First name - owner
JOHN
Last name - owner
WARNER
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20091210000403
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
8729310479
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2018-07-30
First name - owner
THOMAS
Last name - owner
TREON
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20091210000403
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
9739229451
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2016-07-25
First name - owner
SCOTT
Middle name - owner
C
Last name - owner
CLUM
Title - owner
BOARD MEMBER
Enrollment id
O20100816000898
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3173855723
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2018-07-30
First name - owner
CRYSTA
Last name - owner
BLOOMINGDALE
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20100816000898
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3375709702
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2012-06-25
First name - owner
AUSTIE
Middle name - owner
M
Last name - owner
AUKER
Title - owner
FINANCE DIRECTOR
Enrollment id
O20100816000898
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3375709702
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2012-06-25
First name - owner
AUSTIE
Middle name - owner
M
Last name - owner
AUKER
Title - owner
FINANCE DIRECTOR
Enrollment id
O20100816000898
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3779939707
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2023-07-10
First name - owner
ALAN
Last name - owner
AYETTE
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20100816000898
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
4183644123
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2009-10-20
First name - owner
MICHAEL
Middle name - owner
ROBERT
Last name - owner
MAHER
Title - owner
BOARD MEMBER
Enrollment id
O20100816000898
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
4880987080
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-07-27
First name - owner
SONJA
Last name - owner
ETZELL
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20100816000898
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
5092047738
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2019-08-05
First name - owner
JOY
Last name - owner
GREER
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20100816000898
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
5092197467
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2022-08-01
First name - owner
CASSIDY
Last name - owner
HELMAN
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20100816000898
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
5991845612
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2009-10-20
First name - owner
KATHY
Middle name - owner
S
Last name - owner
O'DELL
Title - owner
BOARD MEMBER
Enrollment id
O20100816000898
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
6901905603
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2020-05-22
First name - owner
JARED
Middle name - owner
M
Last name - owner
POLLICK
Title - owner
EXECUTIVE DIRECTOR
Percentage ownership
100
Enrollment id
O20100816000898
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
6901905603
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2020-05-22
First name - owner
JARED
Middle name - owner
M
Last name - owner
POLLICK
Title - owner
EXECUTIVE DIRECTOR
Percentage ownership
100
Enrollment id
O20100816000898
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
7618943952
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2022-08-01
First name - owner
JOHN
Last name - owner
WARNER
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20100816000898
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
8729310479
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2018-07-30
First name - owner
THOMAS
Last name - owner
TREON
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20100816000898
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
9739229451
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2009-10-20
First name - owner
SCOTT
Middle name - owner
C
Last name - owner
CLUM
Title - owner
BOARD MEMBER
Enrollment id
O20110228000767
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3173855723
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2018-07-30
First name - owner
CRYSTA
Last name - owner
BLOOMINGDALE
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20110228000767
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3375709702
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2012-06-25
First name - owner
AUSTIE
Middle name - owner
M
Last name - owner
AUKER
Title - owner
CFO
Percentage ownership
100
Enrollment id
O20110228000767
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3779939707
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2023-07-10
First name - owner
ALAN
Last name - owner
AYETTE
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20110228000767
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
4183644123
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2009-10-20
First name - owner
MICHAEL
Middle name - owner
ROBERT
Last name - owner
MAHER
Title - owner
BOARD MEMBER
Enrollment id
O20110228000767
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
4880987080
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-07-27
First name - owner
SONJA
Last name - owner
ETZELL
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20110228000767
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
5092047738
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2019-08-05
First name - owner
JOY
Last name - owner
GREER
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20110228000767
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
5092197467
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2022-08-01
First name - owner
CASSIDY
Last name - owner
HELMAN
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20110228000767
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
5991845612
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2009-10-20
First name - owner
KATHY
Middle name - owner
S
Last name - owner
O'DELL
Title - owner
BOARD MEMBER
Enrollment id
O20110228000767
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
6901905603
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2020-05-22
First name - owner
JARED
Middle name - owner
M
Last name - owner
POLLICK
Title - owner
CEO
Percentage ownership
100
Enrollment id
O20110228000767
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
6901905603
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2020-05-22
First name - owner
JARED
Middle name - owner
M
Last name - owner
POLLICK
Title - owner
CEO
Percentage ownership
100
Enrollment id
O20110228000767
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
7618943952
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2022-08-01
First name - owner
JOHN
Last name - owner
WARNER
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20110228000767
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
8729310479
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2018-07-30
First name - owner
THOMAS
Last name - owner
TREON
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20110228000767
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
9739229451
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2009-10-20
First name - owner
SCOTT
Middle name - owner
C
Last name - owner
CLUM
Title - owner
BOARD MEMBER
Enrollment id
O20141003001639
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3173855723
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2018-07-30
First name - owner
CRYSTA
Last name - owner
BLOOMINGDALE
Title - owner
BOARD MEMBER
Enrollment id
O20141003001639
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3375709702
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2014-07-23
First name - owner
AUSTIE
Middle name - owner
M
Last name - owner
AUKER
Title - owner
CEO
Enrollment id
O20141003001639
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3375709702
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2014-07-23
First name - owner
AUSTIE
Middle name - owner
M
Last name - owner
AUKER
Title - owner
CFO
Enrollment id
O20141003001639
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
3779939707
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2023-07-10
First name - owner
ALAN
Last name - owner
AYETTE
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20141003001639
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
4183644123
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2002-10-28
First name - owner
MICHAEL
Middle name - owner
ROBERT
Last name - owner
MAHER
Title - owner
BOARD MEMBER
Enrollment id
O20141003001639
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
4880987080
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2015-07-27
First name - owner
SONJA
Last name - owner
ETZELL
Title - owner
BOARD MEMBER
Enrollment id
O20141003001639
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
5092047738
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2019-08-05
First name - owner
JOY
Last name - owner
GREER
Title - owner
BOARD MEMBER
Enrollment id
O20141003001639
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
5092197467
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2022-08-01
First name - owner
CASSIDY
Last name - owner
HELMAN
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20141003001639
Associate id
5698762235
Organization name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Associate id - owner
5991845612
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2014-06-23
First name - owner
KATHY
Middle name - owner
S
Last name - owner
O'DELL
Title - owner
BOARD MEMBER

Showing the first 50 matching records.

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