Healthcare Provider Details

I. General information

NPI: 1164841094
Provider Name (Legal Business Name): CARE ON DEMAND NETWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6975 PROMWAY AVE NW SUITE C
NORTH CANTON OH
44720-7321
US

IV. Provider business mailing address

6975 PROMWAY AVE NW SUITE C
NORTH CANTON OH
44720-7321
US

V. Phone/Fax

Practice location:
  • Phone: 305-915-2105
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MONICA A WINTER
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 305-915-2105