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General NPI Number Information
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NPI Number | 1427517887
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Entity Type | Organization
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Legal Business Name | E & J MCDONNELL INC
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Dates
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Enumeration Date | 03/15/2019
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Last Update Date | 05/23/2019
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Provider Practice Location Address
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Address Line | 8166 MARKET ST STE H
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City | BOARDMAN
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State | OH
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Zip | 44512-6247
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Country | US
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Telephone | 330-510-1890
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Fax | 330-510-1963
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Provider Business Mailing Address
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Address Line | 8166 MARKET ST STE H
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City | BOARDMAN
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State | OH
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Zip | 44512-6247
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Country | US
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Telephone | 330-510-1890
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Fax | 330-510-1963
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Authorized Official
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Title or Position | SECRETARY
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Name | JUANITA MCDONNELL
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Credential | APRN
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Telephone | 330-510-1890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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