Healthcare Provider Details

I. General information

NPI: 1235194937
Provider Name (Legal Business Name): COUNTY OF MAHONING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 11/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 WESTCHESTER DR
YOUNGSTOWN OH
44515-3991
US

IV. Provider business mailing address

50 WESTCHESTER DR
YOUNGSTOWN OH
44515-3991
US

V. Phone/Fax

Practice location:
  • Phone: 330-270-2855
  • Fax: 330-270-9194
Mailing address:
  • Phone: 330-270-2855
  • Fax: 330-270-9194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWARD JANIK
Title or Position: DIRECTOR OF FINANCE/HR
Credential:
Phone: 330-270-2855