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General NPI Number Information
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NPI Number | 1700049095
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Entity Type | Organization
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Legal Business Name | NORTH CENTRAL EMERGENCY ASSOCIATES, LLC
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Dates
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Enumeration Date | 07/07/2008
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 272 BENEDICT AVE
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City | NORWALK
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State | OH
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Zip | 44857-2374
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Country | US
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Telephone | 419-663-1975
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Fax |
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Provider Business Mailing Address
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Address Line | 3090 W MARKET ST SUITE 102
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City | FAIRLAWN
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State | OH
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Zip | 44333-3608
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Country | US
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Telephone | 330-864-7109
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KENNETH L RAUSCHER
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Credential |
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Telephone | 330-864-7109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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