Healthcare Provider Details

I. General information

NPI: 1295836781
Provider Name (Legal Business Name): ESSEX HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 01/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 MARKET AVE N
CANTON OH
44714-2603
US

IV. Provider business mailing address

2 EASTON OVAL SUITE 210
COLUMBUS OH
43219-6036
US

V. Phone/Fax

Practice location:
  • Phone: 330-454-2152
  • Fax:
Mailing address:
  • Phone: 330-454-2152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1084N
License Number StateOH

VIII. Authorized Official

Name: KEITH JAMES YODER
Title or Position: CFO
Credential:
Phone: 614-416-2662