Healthcare Provider Details

I. General information

NPI: 1679309819
Provider Name (Legal Business Name): E4 MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 OHIO AVE
YOUNGSTOWN OH
44504-1822
US

IV. Provider business mailing address

1911 OHIO AVE
YOUNGSTOWN OH
44504-1822
US

V. Phone/Fax

Practice location:
  • Phone: 330-907-2901
  • Fax: 234-719-1510
Mailing address:
  • Phone: 330-907-2901
  • Fax: 234-719-1510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: EVA IBRAHIM
Title or Position: OWNER
Credential: RN
Phone: 330-907-2901