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General NPI Number Information
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NPI Number | 1275578056
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Entity Type | Organization
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Legal Business Name | WESTERN RESERVE CARE SYSTEM
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 500 GYPSY LN
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City | YOUNGSTOWN
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State | OH
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Zip | 44504-1315
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Country | US
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Telephone | 330-884-3223
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Fax | 330-884-5735
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Provider Business Mailing Address
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Address Line | 500 GYPSY LN
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City | YOUNGSTOWN
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State | OH
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Zip | 44504-1315
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT AND COO
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Name | MS. ROXIA B. BOYKIN
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Credential | MPA, RN, CNA
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Telephone | 330-884-1025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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