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General NPI Number Information
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NPI Number | 1831173772
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Entity Type | Organization
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Legal Business Name | MAHONING VALLEY INFUSIONCARE, INC
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 4891 BELMONT AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44505-1015
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Country | US
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Telephone | 330-759-9487
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Fax | 330-759-9564
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Provider Business Mailing Address
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Address Line | 4891 BELMONT AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44505-1015
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Country | US
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Telephone | 330-759-9487
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Fax | 330-759-9564
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Authorized Official
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Title or Position | PRINCIPAL
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Name | KEVIN MCGUIRE
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Credential |
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Telephone | 330-759-9487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 02 0834650
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License Number State | OH
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