MEDICARE: PIONEER PHYSICIANS NETWORK, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1699700823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIONEER PHYSICIANS NETWORK, INC

Provider Business Mailing Address
First Line	:	3515 MASSILLON RD SUITE 300
Second Line	:
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-7819
Country	:	US
Telephone Number	:	330-899-9350
Fax Number	:	330-899-9395

Provider Business Practice Location Address
First Line	:	3300 GREENWICH RD
Second Line	:	SUITE 8
City	:	NORTON
State	:	OH
Zip	:	44203-5714
Country	:	US
Telephone Number	:	330-825-7371
Fax Number	:	330-825-7473

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	KATHLEEN M KOSTELNICK
Credential	:
Telephone Number	:	330-899-9350

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	08/14/2020

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