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General NPI Number Information
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NPI Number | 1124087176
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Entity Type | Organization
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Legal Business Name | FORUM HEALTH
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 510 GYPSY LN
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City | YOUNGSTOWN
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State | OH
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Zip | 44504-1349
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Country | US
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Telephone | 330-884-3951
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Fax |
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Provider Business Mailing Address
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Address Line | 3019 WHISPERING PINES DR
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City | CANFIELD
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State | OH
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Zip | 44406-9649
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Country | US
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Telephone | 330-518-4445
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JAMES MUMFORD
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Credential |
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Telephone | 330-884-3898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | 35080434
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License Number State | OH
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