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General NPI Number Information
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NPI Number | 1689695652
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Entity Type | Organization
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Legal Business Name | AULTMAN HEALTH FOUNDATION
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 04/29/2010
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Provider Practice Location Address
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Address Line | 6100 WHIPPLE AVE NW
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City | NORTH CANTON
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State | OH
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Zip | 44720-7618
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Country | US
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Telephone | 330-305-6999
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Fax | 330-305-6997
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Provider Business Mailing Address
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Address Line | 6100 WHIPPLE AVE NW
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City | NORTH CANTON
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State | OH
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Zip | 44720-7618
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Country | US
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Telephone | 330-305-6999
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Fax | 330-305-6997
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | G SCOTT MCDONOUGH
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Credential | MD
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Telephone | 330-834-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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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 | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 021051600
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License Number State | OH
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