Healthcare Provider Details
I. General information
NPI: 1679887897
Provider Name (Legal Business Name): PARAGON HEALTH ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/29/2010
Last Update Date: 06/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
28 CONSERVATORY DR SUITE C
BARBERTON OH
44203-4275
US
IV. Provider business mailing address
1 PARK WEST BLVD SUITE 200
AKRON OH
44320-4218
US
V. Phone/Fax
- Phone: 330-869-9777
- Fax: 330-865-6011
- Phone: 330-869-9777
- Fax: 330-865-6011
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KIMBERLY
A
WHITE
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 330-869-9777