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General NPI Number Information
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NPI Number | 1790808970
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Entity Type | Organization
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Legal Business Name | EAST HOLMES FAMILY CARE INC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/01/2014
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Provider Practice Location Address
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Address Line | 2040 TR 661
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City | DUNDEE
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State | OH
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Zip | 44624
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Country | US
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Telephone | 330-359-5989
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Fax | 330-359-3590
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Provider Business Mailing Address
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Address Line | PO BOX 366
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City | BERLIN
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State | OH
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Zip | 44610
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Country | US
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Telephone | 330-359-5989
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Fax | 330-359-3590
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Authorized Official
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Title or Position | TREASURER-PHYSICIAN
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Name | DR. ROBERT KIM KORNHAUS
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Credential | MD
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Telephone | 330-893-3771
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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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