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General NPI Number Information
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NPI Number | 1417935503
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Entity Type | Organization
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Legal Business Name | AVAMAR CENTER FOR ENDOSCOPY,INC
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Dates
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Enumeration Date | 01/09/2006
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 9225 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44484-5517
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Country | US
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Telephone | 330-372-7470
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Fax | 330-372-7480
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Provider Business Mailing Address
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Address Line | 9225 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44484-5517
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Country | US
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Telephone | 330-372-7470
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Fax | 330-372-7480
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. BARBARA E. STEINBECK
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Credential |
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Telephone | 330-372-7470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number | 0624AS
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License Number State | OH
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