Healthcare Provider Details

I. General information

NPI: 1114494119
Provider Name (Legal Business Name): MOHR HEALTH CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2018
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12415 HOOVER AVE NW
UNIONTOWN OH
44685-7378
US

IV. Provider business mailing address

12415 HOOVER AVE NW
UNIONTOWN OH
44685-7378
US

V. Phone/Fax

Practice location:
  • Phone: 330-546-5015
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: VICKI MOHR
Title or Position: AUTHORIZED OFFICIAL
Credential: NP-C
Phone: 330-546-5015