Healthcare Provider Details
I. General information
NPI: 1659564904
Provider Name (Legal Business Name): AURORA HEALTH & WELLNESS MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/21/2007
Last Update Date: 10/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
45 N CHILLICOTHE RD
AURORA OH
44202-8702
US
IV. Provider business mailing address
45 N CHILLICOTHE RD
AURORA OH
44202-8702
US
V. Phone/Fax
- Phone: 330-562-3142
- Fax: 330-995-0230
- Phone: 330-562-3142
- Fax: 330-995-0230
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANTHONY
J
BADALAMENTI
Title or Position: OWNER
Credential: D.C.
Phone: 330-562-3142