Healthcare Provider Details

I. General information

NPI: 1841241825
Provider Name (Legal Business Name): BARBERTON HEALTH SYSTEM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 5TH ST NE
BARBERTON OH
44203-3332
US

IV. Provider business mailing address

PO BOX 714139
COLUMBUS OH
43271-4139
US

V. Phone/Fax

Practice location:
  • Phone: 330-745-1611
  • Fax: 330-848-7820
Mailing address:
  • Phone: 330-745-1611
  • Fax: 330-848-7820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number1279
License Number StateOH

VIII. Authorized Official

Name: LAURIE HOLTSFORD
Title or Position: DIRECTOR, BUSINESS OFFICE SERVICES
Credential:
Phone: 615-465-7466