Healthcare Provider Details
I. General information
NPI: 1295147585
Provider Name (Legal Business Name): WILLOW CLAIMS PROCESSING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2014
Last Update Date: 06/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
507 OAK HILL AVENUE 551 NEW COURT
YOUNGSTOWN OH
44502
US
IV. Provider business mailing address
507 OAK HILL AVENUE 551 NEW COURT
YOUNGSTOWN OH
44502
US
V. Phone/Fax
- Phone: 330-301-5412
- Fax:
- Phone: 330-301-5412
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
TONYA
RAE
WOOLENSACK
Title or Position: CEO
Credential:
Phone: 330-301-5412