Healthcare Provider Details

I. General information

NPI: 1649693094
Provider Name (Legal Business Name): 910 RAPID CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2014
Last Update Date: 03/09/2020
Certification Date: 03/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 BOARDMAN CANFIELD RD
BOARDMAN OH
44512-4218
US

IV. Provider business mailing address

910 BOARDMAN CANFIELD RD
BOARDMAN OH
44512-4218
US

V. Phone/Fax

Practice location:
  • Phone: 330-965-0075
  • Fax: 330-965-3790
Mailing address:
  • Phone: 330-965-0075
  • Fax: 330-965-3790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE G. ELLIS JR.
Title or Position: M.D.
Credential: M.D.
Phone: 330-965-0075