1376779702 NPI number — ACUTE CARE SURGERY SERVICE AT AKRON

Table of content: (NPI 1376779702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376779702 NPI number — ACUTE CARE SURGERY SERVICE AT AKRON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACUTE CARE SURGERY SERVICE AT AKRON
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376779702
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 AKRON GENERAL AVE
Provider Second Line Business Mailing Address:
ATTN DOREEN MEREDITH
Provider Business Mailing Address City Name:
AKRON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44307-2432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-344-5056
Provider Business Mailing Address Fax Number:
330-344-2930

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 AKRON GENERAL AVE
Provider Second Line Business Practice Location Address:
ACC. BLDG.
Provider Business Practice Location Address City Name:
AKRON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44307-2432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-344-5180
Provider Business Practice Location Address Fax Number:
330-344-5669
Provider Enumeration Date:
05/29/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LONGVILLE
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CHIEF ACCOUNTING OFFICER AND CONTRO
Authorized Official Telephone Number:
216-444-2296

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2086S0102X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086S0127X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3010904 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".