=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316059710
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DRS. HILL & THOMAS CO.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2131 LAKE AVE
-----------------------------------------------------
City | ASHTABULA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44004-3466
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-998-2222
-----------------------------------------------------
Fax | 440-998-2238
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25001 EMERY RD SUITE 100
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44128-5626
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-831-9786
-----------------------------------------------------
Fax | 216-831-2425
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF FINANCIAL OFFICER
-----------------------------------------------------
Name | MR. JEFFREY A. KAMPMAN
-----------------------------------------------------
Credential | CPA
-----------------------------------------------------
Telephone | 216-831-9786
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0200X
-----------------------------------------------------
Taxonomy Name | Radiology Clinic/Center
-----------------------------------------------------
License Number | 0859IC
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------