=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740381227
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PLANNED PARENTHOOD OF SUMMIT, PORTAGE & MEDINA COUNTIES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 903 E AURORA RD
-----------------------------------------------------
City | MACEDONIA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44056-1905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-468-5887
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 903 E AURORA RD
-----------------------------------------------------
City | MACEDONIA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44056-1905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-468-5887
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF PATIENT SERVICES
-----------------------------------------------------
Name | SUSAN HIRT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 330-535-2674
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0005X
-----------------------------------------------------
Taxonomy Name | Ambulatory Family Planning Facility
-----------------------------------------------------
License Number | 35032759
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------