Healthcare Provider Details

I. General information

NPI: 1699700823
Provider Name (Legal Business Name): PIONEER PHYSICIANS NETWORK, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 08/14/2020
Certification Date: 08/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GREENWICH RD SUITE 8
NORTON OH
44203-5714
US

IV. Provider business mailing address

3515 MASSILLON RD SUITE 300
UNIONTOWN OH
44685-7819
US

V. Phone/Fax

Practice location:
  • Phone: 330-825-7371
  • Fax: 330-825-7473
Mailing address:
  • Phone: 330-899-9350
  • Fax: 330-899-9395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN M KOSTELNICK
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 330-899-9350