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General NPI Number Information
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NPI Number | 1619090891
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Entity Type | Organization
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Legal Business Name | FOUNDATION HEALTH CARE, INC.
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 755 BOARDMAN-CANFILED ROAD SUITE F5
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City | YOUNGSTOWN
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State | OH
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Zip | 44514
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Country | US
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Telephone | 330-726-3806
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Fax | 330-726-9450
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Provider Business Mailing Address
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Address Line | 6615 CLINGAN RD SUITE D
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City | POLAND
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State | OH
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Zip | 44514-2196
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Country | US
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Telephone | 330-707-1425
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Fax | 330-757-2814
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL B EVAN
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Credential | MD
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Telephone | 330-707-1425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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