Healthcare Provider Details

I. General information

NPI: 1851377949
Provider Name (Legal Business Name): HEALTH CARE PROVIDERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6674 TIPPECANOE RD STE 1
CANFIELD OH
44406-9149
US

IV. Provider business mailing address

6674 TIPPECANOE RD STE 1
CANFIELD OH
44406-9149
US

V. Phone/Fax

Practice location:
  • Phone: 330-533-8490
  • Fax: 330-533-8783
Mailing address:
  • Phone: 330-533-8490
  • Fax: 330-533-8783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES CHARLES DEMIDOVICH
Title or Position: PRESIDENT
Credential: DO
Phone: 330-533-8490