Healthcare Provider Details

I. General information

NPI: 1487380770
Provider Name (Legal Business Name): HLES OF OHIO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 W 5TH ST
EAST LIVERPOOL OH
43920-2498
US

IV. Provider business mailing address

533 4TH AVE
HUNTINGTON WV
25701-1318
US

V. Phone/Fax

Practice location:
  • Phone: 330-385-7200
  • Fax:
Mailing address:
  • Phone: 800-377-8721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER ANN MOORE
Title or Position: CEO
Credential:
Phone: 415-435-4591